The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review
BackgroundHashimoto’s encephalopathy (HE) is a controversial immunological neuropsychiatric disease, with a poorly understood pathogenesis. It is characterized by symptoms of acute or subacute encephalopathy which usually occur in the presence of elevated levels of antithyroid antibodies. Even thoug...
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| Format: | Article |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1243787/full |
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| author | Victoriţa Şorodoc Victoriţa Şorodoc Mihai Constantin Mihai Constantin Andreea Asaftei Cătălina Lionte Cătălina Lionte Alexandr Ceasovschih Alexandr Ceasovschih Oana Sîrbu Oana Sîrbu Raluca Ecaterina Haliga Raluca Ecaterina Haliga Laurenţiu Şorodoc Laurenţiu Şorodoc |
| author_facet | Victoriţa Şorodoc Victoriţa Şorodoc Mihai Constantin Mihai Constantin Andreea Asaftei Cătălina Lionte Cătălina Lionte Alexandr Ceasovschih Alexandr Ceasovschih Oana Sîrbu Oana Sîrbu Raluca Ecaterina Haliga Raluca Ecaterina Haliga Laurenţiu Şorodoc Laurenţiu Şorodoc |
| author_sort | Victoriţa Şorodoc |
| collection | DOAJ |
| description | BackgroundHashimoto’s encephalopathy (HE) is a controversial immunological neuropsychiatric disease, with a poorly understood pathogenesis. It is characterized by symptoms of acute or subacute encephalopathy which usually occur in the presence of elevated levels of antithyroid antibodies. Even though it is also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), some cases appear to be steroid-resistant. This review examined whether treatment of Hashimoto’s encephalopathy with intravenous immunoglobulin (IVIG) is associated with better clinical outcomes than the standard therapy. Additionally, we presented a case of a 59-year-old man who presented with severe neurological manifestations and was successfully treated with intravenous immunoglobulin.MethodsThe online databases PubMed and EMBASE were searched.ResultsA total of 1,365 articles were identified. After the deletion of 112 duplicates, 1,253 studies were screened by evaluating the title and abstract, focusing on Hashimoto’s encephalopathy cases where IVIG were used. 846 studies were excluded because they were not relevant to the topic or included pediatric population. Therefore, 407 full-text articles were assessed for eligibility. The final analysis included 14 eligible articles after 393 were excluded (irrelevant texts, not written in English, full-text not available). In the majority of the selected case-reports, IVIG was associated with a good outcome, sometimes even with dramatic improvements in patient’s status.ConclusionIn last years, intravenous immunoglobulin therapy proved its utility in Hashimoto’s encephalopathy’s treatment, being a well tolerated therapy associated with remarkable improvement in patient’s status. Further research is still needed in order to define the optimal treatment protocol for Hashimoto’s encephalopathy and to establish if intravenous immunoglobulin can also be used as a first-line therapy, alone or in combination with steroids. |
| first_indexed | 2024-03-12T02:00:12Z |
| format | Article |
| id | doaj.art-5f37b5f490b04b358539ff2d01127a6a |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T02:00:12Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-5f37b5f490b04b358539ff2d01127a6a2023-09-07T16:45:58ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-09-011410.3389/fneur.2023.12437871243787The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based reviewVictoriţa Şorodoc0Victoriţa Şorodoc1Mihai Constantin2Mihai Constantin3Andreea Asaftei4Cătălina Lionte5Cătălina Lionte6Alexandr Ceasovschih7Alexandr Ceasovschih8Oana Sîrbu9Oana Sîrbu10Raluca Ecaterina Haliga11Raluca Ecaterina Haliga12Laurenţiu Şorodoc13Laurenţiu Şorodoc142nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania2nd Rheumatology Department, Clinical Rehabilitation Hospital, Iasi, Romania2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania2nd Internal Medicine Department, Sf. Spiridon Clinical Emergency Hospital, Iasi, RomaniaInternal Medicine Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, Iasi, RomaniaBackgroundHashimoto’s encephalopathy (HE) is a controversial immunological neuropsychiatric disease, with a poorly understood pathogenesis. It is characterized by symptoms of acute or subacute encephalopathy which usually occur in the presence of elevated levels of antithyroid antibodies. Even though it is also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), some cases appear to be steroid-resistant. This review examined whether treatment of Hashimoto’s encephalopathy with intravenous immunoglobulin (IVIG) is associated with better clinical outcomes than the standard therapy. Additionally, we presented a case of a 59-year-old man who presented with severe neurological manifestations and was successfully treated with intravenous immunoglobulin.MethodsThe online databases PubMed and EMBASE were searched.ResultsA total of 1,365 articles were identified. After the deletion of 112 duplicates, 1,253 studies were screened by evaluating the title and abstract, focusing on Hashimoto’s encephalopathy cases where IVIG were used. 846 studies were excluded because they were not relevant to the topic or included pediatric population. Therefore, 407 full-text articles were assessed for eligibility. The final analysis included 14 eligible articles after 393 were excluded (irrelevant texts, not written in English, full-text not available). In the majority of the selected case-reports, IVIG was associated with a good outcome, sometimes even with dramatic improvements in patient’s status.ConclusionIn last years, intravenous immunoglobulin therapy proved its utility in Hashimoto’s encephalopathy’s treatment, being a well tolerated therapy associated with remarkable improvement in patient’s status. Further research is still needed in order to define the optimal treatment protocol for Hashimoto’s encephalopathy and to establish if intravenous immunoglobulin can also be used as a first-line therapy, alone or in combination with steroids.https://www.frontiersin.org/articles/10.3389/fneur.2023.1243787/fullHashimoto’s encephalopathyautoimmune encephalopathyanti-thyroid peroxidaseanti-thyroglobulinintravenous immunoglobulinalpha-enolase |
| spellingShingle | Victoriţa Şorodoc Victoriţa Şorodoc Mihai Constantin Mihai Constantin Andreea Asaftei Cătălina Lionte Cătălina Lionte Alexandr Ceasovschih Alexandr Ceasovschih Oana Sîrbu Oana Sîrbu Raluca Ecaterina Haliga Raluca Ecaterina Haliga Laurenţiu Şorodoc Laurenţiu Şorodoc The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review Frontiers in Neurology Hashimoto’s encephalopathy autoimmune encephalopathy anti-thyroid peroxidase anti-thyroglobulin intravenous immunoglobulin alpha-enolase |
| title | The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review |
| title_full | The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review |
| title_fullStr | The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review |
| title_full_unstemmed | The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review |
| title_short | The use of intravenous immunoglobulin in the treatment of Hashimoto’s encephalopathy: case based review |
| title_sort | use of intravenous immunoglobulin in the treatment of hashimoto s encephalopathy case based review |
| topic | Hashimoto’s encephalopathy autoimmune encephalopathy anti-thyroid peroxidase anti-thyroglobulin intravenous immunoglobulin alpha-enolase |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1243787/full |
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