ECE2023 Eposter Presentations Thyroid (128 abstracts)
Hashimoto’s encephalopathy: a case report
Faten Haj Kacem Akid 1 , Raida Ben Salah 2 , Siddiqa Soomauroo 1 , Abdel Mouhaymen Missaoui 1 , Sarra Chouaib 1 , Fatma Mnif 1 , Faten Frikha 2 , Zouheir Bahloul 2 & Mohamed Abid 1
1Hedi Chaker University Hospital, Department of Endocrinology, Sfax, Tunisia; 2Hedi Chaker University Hospital, Department of Internal Medicine, Sfax, Tunisia
Introduction: Hashimoto’s encephalopathy (HE) is characterised by the combination of clinical signs of encephalitis and autoimmune thyroiditis with elevated levels of antithyroid antibodies (ATA). It is a rare condition and its etiopathogenesis is still poorly understood.
Observation: we present a 33-year-old female patient who was hospitalized for gait disorders. The diagnosis of a chronic cerebellar syndrome related to Hashimoto’s encephalitis was retained in view of an elevated TSH level and positive ATA, but the patient was clinically euthyroid. A series of investigations was performed: a cervical ultrasound scan showing a diffuse multi-micronodular goiter. A cerebral magnetic resonance imaging showed a cerebellar atrophy without focal or confluent white matter hyperintensities. A lumbar puncture was performed, showing no hyperproteinorrachia or pleocytosis. The electroencephalogram was normal. Other causes such as tumoural, toxic, malformative and degenerative were ruled out.
Discussion/Conclusion: HE is a rare entity, which was first described in 1966. It is characterised by aspecific neurological and/or psychiatric symptoms. Biologically, it is associated with an increase in ATA in the serum and sometimes in the cerebrospinal fluid of affected patients. The pathogenesis of HE is unknown. The role of ATA is a matter of debate. Indeed, several studies have shown that anti-thyroperoxidase antibodies have a high prevalence in asymptomatic individuals. This entity is usually very sensitive to corticosteroid therapy. It is a diagnosis by exclusion.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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