Hashimoto’s Encephalopathy: An Unusual Cause of Autoimmune Encephalopathy in a Clinically and Biochemically Euthyroid Patient

  • Senthil Chandrasekaram Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
  • Emily Mudenha Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
  • Buddhike A Mendis Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
  • Antal Szabo Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield
  • Devaka JS Fernando Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield Department of Diabetes and Endocrinology, University of Sheffield, Sheffield Postgraduate Medical Centre, Sheffield Hallam University, Sheffield

Abstract

Objectives: To highlight the occurrence of Hashimoto’s encephalopathy – a steroid-responsive encephalopathy associated with elevated antithyroid antibodies.

Material and methods: We describe a clinically and biochemically euthyroid patient with an encephalopathy presenting with headache, mild confusion and personality changes for 6 weeks and tonic–clonic seizures upon admission

Results: There was no obvious infective or metabolic cause. The patient had a high titre of antithyroid antibodies and responded to steroid therapy.

Conclusion: This uncommon disease needs to be considered in patients presenting with neurological symptoms that remain unexplained after routine standard investigations, even when the patient is euthyroid. Early diagnosis is important, as this is a treatable condition.

Author Biographies

Senthil Chandrasekaram ,
Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield

International Clinical Fellow

Department of Diabetes and Endocrinology

Emily Mudenha ,
Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield

Specialist Registrar

Department of Diabetes and Endocrinology

Buddhike A Mendis ,
Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield

Consultant Endocrinologist

Department of Diabetes and Endocrinology

Antal Szabo ,
Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield

Consultant Neurolgist

Department of Neurology

Devaka JS Fernando ,
Department of Endocrinology and Diabetes, King’s Mill Hospital, Sherwood Forest Hospital NHS Foundation Trust, Sutton-in-Ashfield Department of Diabetes and Endocrinology, University of Sheffield, Sheffield Postgraduate Medical Centre, Sheffield Hallam University, Sheffield Consultant Physician Honorary Professor and Head of Department

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  • Published: 2014-10-14

    Issue: Vol. 1 (2014) (view)

    Section: Articles

    How to cite:
    1.
    Chandrasekaram S, Mudenha E, Mendis BA, Szabo A, Fernando DJ. Hashimoto’s Encephalopathy: An Unusual Cause of Autoimmune Encephalopathy in a Clinically and Biochemically Euthyroid Patient. EJCRIM 2014;1 doi:10.12890/2014_000141.