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CASE REPORT
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| Hashimoto's encephalopathy in the setting of subclinical hypothyroidism |
| Vasile M Bota1, Dominic F Corrigan2 |
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1Internal Medicine Resident, Boston University School of Medicine and Roger Williams Medical Center, Providence, RI
2Associate Clinical Professor of Medicine, Division of Endocrinology, The Warren Alpert Medical School of Brown University and Rhode Island Hospital, Providence, RI
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doi:10.5348/ijcri-2011-04-30-CR-5
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Address correspondence to: Dr. Vasile M Bota Mailing address: Department of Medical Education Roger Williams Medical Center 825 Chalkstone Ave Providence RI, 02908 USA Phone: 401-456-2000 Fax: 401-456-6809 Email: vmbota@gmail.com, vbota@rwmc.org |
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| How to cite this article: |
| Bota VM, Corrigan DF. Hashimoto's encephalopathy in the setting of subclinical hypothyroidism. International Journal of Case Reports and Images 2011;2(4):19-22. |
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Abstract
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Introduction:
We describe the occurrence of Hashimoto's encephalopathy in the setting of subclinical hypothyroidism. We report the unusual presentation of a 62-year-old female with subclinical hypothyroidism and severe cognitive impairment. Pertinent literature is discussed.
Case Report: In September 2008 the patient experienced episodic dizziness and gradual cognitive impairment. An outpatient neurological evaluation was non diagnostic. In January 2009 she experienced severe gait imbalance, dysarthria and handwriting change. Despite partial improvement, three months later her symptoms recurred accompanied by confusion, amnesia and generalized tonic-clonic seizures. She underwent complete neurologic investigations without establishment of a clear diagnosis. Subsequent testing for antithyroglobulin antibody and antithyroid peroxidase antibody were 2020.4 IU/ml and 186.8 IU/ml respectively (reference range: 0-60 IU/ml for both tests). A diagnosis of Hashimoto`s encephalopathy was made and she was started on glucocorticoids with a rapid clinical response. She was switched to oral prednisone, with a slow taper. Conclusion: Hashimoto's encephalopathy is an association of encephalopathy with elevated serum antithyroid antibody levels and has a favorable clinical response to glucocorticoid therapy. Hashimoto's encephalopathy should be suspected in every patient with encephalopathy without detectable cause, especially in the setting of an underlying thyroid abnormality. | |
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Key Words:
Hashimoto's encephalopathy, Subclinical hypothyroidism, Hashimoto, Corticosteroid responsive encephalopathy, Autoimmune thyroiditis, Encephalopathy
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Author Contributions:
Vasile M Bota - Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published Dominic F Corrigan - Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission:
The corresponding author is the guarantor of submission |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Vasile M Bota et. al. 2011; This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited . (Please see copyright policy for more information.) |
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