Resumen
INTRODUCCIÓN:La encefalopatía asociada a enfermedad tiroidea autoinmune se caracteriza por un inicio insidioso de síntomas neuropsiquiátricos que incluyen alteración de la función cognoscitiva, cambios del comportamiento, crisis convulsivas y trastornos del movimiento.
REPORTE DE CASO:Hombre de 69 años con antecedente de hipotiroidismo primario que consultó por dos semanas de alteración de la memoria, confusión y trastorno del lenguaje, asociados a hiperreflexia y temblor generalizado. Los estudios mostraron nivel de hormona tiroidea y títulos de anticuerpos antitiroideos elevados, líquido cefalorraquídeo con aumento de proteínas y anticuerpos antineuronales negativos, neuroimagen normal y electroencefalograma con alteraciónes inespecíficas. Posterior a descartar otras etiologías, se hizo el diagnóstico de encefalopatía asociada a enfermedad tiroidea autoinmune y se inició manejo con esteroides, con los que presentó una mejoría clínica significativa.
DISCUSIÓN:La encefalopatía asociada a enfermedad tiroidea autoinmune es un trastorno complejo que requiere un diagnóstico oportuno y rápido. En todos los pacientes con síntomas neuropsiquiátricos agudos o subagudos, y sin causa clara, es pertinente solicitar un perfil de anticuerpos antitiroideos independiente de la función tiroidea basal.
Citas
Castillo P, Woodruff B, Caselli R, Vernino S, Lucchinetti C, Swanson J, et al. Steroid-Responsive Encephalopathy Associated With Autoimmune Thyroiditis. Arch Neurol. 2006;63(2):197.
Budson A, Solomon P. Memory loss, alzheimers disease and dementia. 3.a ed. Philadelphia: Elsevier, Inc; 2021.
Olmez I, Moses H, Sriram S, Kirshner H, Lagrange AH, Pawate S. Diagnostic and therapeutic aspects of Hashimoto's encephalopathy. J Neurol Sci. 2013;331(1-2):67-71.
Mattozzi S, Sabater L, Escudero D, Ariño H, Armangue T, Simabukuro M, et al. Hashimoto encephalopathy in the 21st century. Neurology. 2020;94(2):e217-24.
Tyler KL, Rüegg S. The neuromythology of Hashimoto encephalopathy: The emperor has no clothes. Neurology. 2020;94(2):55-6.
Crotty GF, Doherty C, Solomon IH, Berry JD, Samuels MA. Learning from history: Lord Brain and Hashimoto's encephalopathy. Pract Neurol. 2019;19(4):316-20.
Chen KA, Brilot F, Dale RC, Lafferty AR, Andrews PI. Hashimoto's encephalopathy and anti-MOG antibody encephalitis: 50 years after Lord Brain's description. Eur J Paediatr Neurol. 2017;21(6):898-901.
Chong JY, Rowland LP, Utiger RD. Hashimoto Encephalopathy: Syndrome or Myth? Arch Neurol. 2003;60(2):164.
Zhou JY, Xu B, Lopes J, Blamoun J, Li L. Hashimoto encephalopathy: literature review Acta Neurol Scand. 2017;135(3):285-90.
Chaigne B, Mercier E, Garot D, Legras A, Dequin PF, Perrotin D. Hashimoto's Encephalopathy in the Intensive Care Unit. Neurocrit Care. 2013;18(3):386-90.
Brain L. Hashimoto's Disease and Encephalopathy. The Lancet. 1966;288(7462):512-4.
Mantilla SE, Guerrero A, Montoya LE, Giraldo K, Aguirre HD. Encefalopatía de Hashimoto: reporte de caso y revisión de la literatura. Neurol Argent. 2019;11(3):177-80.
Cheriyath P, Nookala V, Srivastava A, Qazizadeh S, Fischman D. Acute confusional state caused by Hashimoto's encepha-lopathy in a patient with hypothyroidism: a case report. Cases J. 2009;2(1):7967.
Matsunaga A, Ikawa M, Yoneda M. Hashimoto encephalopathy. Clin Exp Neuroimmunol. 2019;10(4):226-33.
Chiarello P, Talarico V, Nicoletti A, Rodio B, Arcuri PP, Bosco D, et al. Hashimoto encephalopathy: a case report and a short revision of current literature: Hashimoto encephalopathy in pediatric age. Acta Bio Medica Atenei Parm. 2020;91(3):e2020087.
Armangue T, Petit-Pedrol M, Dalmau J. Autoimmune Encephalitis in Children. J Child Neurol. 2012;27(11):1460-9.
Dale RC. Immune-Mediated Epilepsy, Movement Disorders, and Hashimoto's Encephalopathy in Children. En: Swaiman's Pediatric Neurology [Internet]. Elsevier; 2017 [citado 28 de enero de 2022]. p. 932-7. Disponible en: Disponible en: https://linkinghub.elsevier.com/retrieve/pii/B9780323371018001193
Ferracci F, Bertiato G, Moretto G. Hashimoto's encephalopathy: epidemiologic data and pathogenetic considerations. J Neurol Sci. 2004;217(2):165-8.
Mocellin R, Walterfang M, Velakoulis D. Hashimoto's Encephalopathy: Epidemiology, Pathogenesis and Management. CNS Drugs. 2007;21(10):799-811.
Churilov LP, Sobolevskaia PA, Stroev YI. Thyroid gland and brain: Enigma of Hashimoto's encephalopathy. Best Pract Res Clin Endocrinol Metab. 2019;33(6):101364.
Graham BR, Shiff N, Nour M, Hasal S, Huntsman R, Almubarak S. Hashimoto Encephalopathy Presenting With Stroke-Like Episodes in an Adolescent Female: A Case Report and Literature Review Pediatr Neurol. 2016;59:62-70.
Pinedo-Torres I, Paz-Ibarra JL. Current knowledge on Hashimoto's encephalopathy: a literature review. Medwave. 2018;18(06):e7298-e7298.
Laurent C, Capron J, Quillerou B, Thomas G, Alamowitch S, Fain O, et al. Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT): Characteristics, treatment and outcome in 251 cases from the literature. Autoimmun Rev. 2016;15(12):1129-33.
Kang WH, Na JY, Kim MK, Yoo BG. Hashimoto's Encephalopa-thy Presenting with Acute Cognitive Dysfunction and Convulsion. J Epilepsy Res. 2013;3(2):70-3.
Saleem S, Maryam J, Sajaad A, Wasay M. Hashimoto's Encephalopathy: A Remediable Cause of Unexplained Encephalopathy. J Clin Stud Med Case Rep. 2021;8(1):1-4.
Ferracci F, Carnevale A. The neurological disorder associated with thyroid autoimmunity. J Neurol. 2006;253(8):975-84.
Peschen-Rosin R, Schabet M, Dichgans J. Manifestation of Hashimoto's Encephalopathy Years before Onset of Thyroid Disease. Eur Neurol. 1999;41(2):79-84.
Alix JJP, Shaw PJ. Thyroid Disease and the Nervous System. En: Aminoff's Neurology and General Medicine [Internet]. Elsevier; 2014: 329-50. Disponible en: https://linkinghub.elsevier.com/retrieve/pii/B9780124077102000187
Huang X, Yu Y, Zhang H, Liu J, Sun Y, Chang M, et al. Hashimoto encephalopathy associated with hyperthyroidism: A case report. Exp Ther Med. 2014;8(2):515-8.
Tamagno G, Celik Y, Simó R, Dihné M, Kimura K, Gelosa G, et al. Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes. BMC Neurol. 2010;10(1):27.
Payer J, Petrovic T, Lisy L, Langer P. Hashimoto Encephalopathy: A Rare Intricate Syndrome. Int J Endocrinol Metab. 2012;10(2):506-14.
Matera E, Gabellone A, Petruzzelli MG, Marzulli L, Furente F, Margari L. Anti-N-Methyl-D-Aspartate Receptor Encephalitis with Serum Anti-Thyroid Antibodies: A Case Report and Literature Review. Am J Case Rep [Internet]. 2021: 22. Disponible en: https://www.amjcaserep.com/abstract/index/idArt/931104
Vanderpump MPJ, Tunbrldge WMG, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham Survey Clin Endocrinol (Oxf). 1995;43(1):55-68.
Anderson NE, Barber PA. Limbic encephalitis - a review J Clin Neurosci. 2008;15(9):961-71.
Tian X, Wang X, Kwan P. Editorial: Advances in Steroid-Responsive Encephalopathy. Front Neurol. 2020;11:793.
Zheng Y, Zhang Y, Cai M, Lai N, Chen Z, Ding M. Central Nervous System Involvement in ANCA-Associated Vasculitis: What Neurologists Need to Know. Front Neurol. 2019;9:1166.
Rodien P, Madec AM, Ruf J, Rajas F, Bornet H, Carayon P, et al. Antibody-dependent cell-mediated cytotoxicity in autoimmune thyroid disease: relationship to antithyroperoxidase antibodies. J Clin Endocrinol Metab. 1996;81(7):2595-600.
Graus F, Titulaer MJ, Balu R, Benseler S, Bien CG, Cellucci T, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol. 2016;15(4):391-404.
Fatemi S, Bedri J, Nicoloff JT. Encephalopathy Associated with Hashimoto's Thyroiditis: Use of Serum Immunoglobulin G as a Marker of Disease Activity. Thyroid. 2003;13(2):227-8.
Grommes C, Griffin C, Downes KA, Lerner AJ. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Diffusion MR Imaging Changes: Fig 1. Am J Neuroradiol. 2008;29(8):1550-1.
Mahad DJ, Staugaitis S, Ruggieri P, Parisi J, IKeinschmidt-Demasters BK, Lassmann H, et al. Steroid-responsive encephalopathy associated with autoimmune thyroiditis and primary CNS demy-elination. J Neurol Sci . 2005;228(1):3-5.
Ramalho J, Castillo M. Hashimoto's encephalopathy. Radiol Case Rep. 2011;6(1):445.
Rodriguez AJ, Jicha GA, Steeves TDL, Benarroch EE, Westmoreland BF. EEG Changes in a Patient With Steroid-Responsive Encephalopathy Associated With Antibodies to Thyroperoxidase (SREAT, Hashimoto's Encephalopathy). J Clin Neurophysiol. 2006;23(4):371-3.
Kothbauer-Margreiter I, Sturzenegger M, Komor J, Baumgartner R, Hess CW. Encephalopathy associated with Hashimoto thyroiditis: Diagnosis and treatment. J Neurol. 1996;243(8):585-93.
Tang Y, Xing Y, Lin MT, Zhang J, Jia J. Hashimoto's encephalopathy cases: Chinese experience. BMC Neurol . diciembre de 2012;12(1):60.
Cooper BL, Appel SE, Ammar HM. A young female with urinary retention - Hashimoto's Encephalopathy. Am J Emerg Med. 2017;35(6):943.e1-943.e2.
Kim J, Shin H, Kang K, Kwon O, Park JM, Kim BK, et al. Hashimoto's encephalopathy: South Korean experiences. Acta Neurol Belg. 2014;114(3):209-16.
Marshall GA, Doyle JJ. Long-Term Treatment of Hashimoto's Encephalopathy. J Neuropsychiatry Clin Neurosci. 2006;18(1):14-20.
Mijajlovic M, Mirkovic M, Dackovic J, Zidverc-Trajkovic J, Sternic N. Clinical manifestations, diagnostic criteria and therapy of Hashimoto's encephalopathy: Report of two cases. J Neurol Sci . 2010;288(1-2):194-6.
Hussain NS, Rumbaugh J, Kerr D, Nath A, Hillis AE. Effects of prednisone and plasma exchange on cognitive impairment in Hashimoto encephalopathy. Neurology. 2005;64(1):165-6.
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.