Hashimoto's Encephalopathy

被引:101
作者
Schiess, Nicoline [1 ]
Pardo, Carlos A. [1 ,2 ]
机构
[1] Johns Hopkins Univ, Sch Med, Dept Neurol, Div Neuroimmunol & Neuroinfect Disorders, Baltimore, MD 21287 USA
[2] Johns Hopkins Univ, Sch Med, Dept Pathol Neuropathol, Baltimore, MD 21287 USA
来源
YEAR IN NEUROLOGY 2008 | 2008年 / 1142卷
基金
美国国家卫生研究院;
关键词
Hashimoto's encephalopathy; dementia; seizures; encephalitis; steroids;
D O I
10.1196/annals.1444.018
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Hashimoto's encephalopathy (HE) is a controversial neurological disorder that comprises a heterogenous group of neurological symptoms that manifest in patients with high titers of antithyroid antibodies. Clinical manifestations of HE may include encephalopathic features such as seizures, behavioral and psychiatric manifestations, movement disorders, and coma. Although it has been linked to cases of Hashimoto's thyroiditis or thyroid dysfunction, the most common immunological feature of HE is the presence of high titers of antithyroglobulin or anti-TPO (antimicrosomal) antibodies. At present, it is unclear whether antithyroid antibodies represent an immune epiphenomenon in a subset of patients with encephalopathic processes or they are really associated with pathogenic mechanisms of the disorder. The significance of classifying encephalopathies under the term HE will be determined in the future once the relevance of the role of antithyroid antibodies is demonstrated or dismissed by more detailed experimental and immunopathological studies. The responsiveness of HE to steroids or other therapies such as plasmapheresis supports the hypothesis that this is a disorder that involves immune pathogenic mechanisms. Further controlled studies of the use of steroids, plasmapheresis, or immunosuppressant medications are needed in the future to prove the concept of the pathogenic role of antithyroid antibodies in HE.
引用
收藏
页码:254 / 265
页数:12
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