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A case of Hashimoto’s encephalopathy misdiagnosed as viral encephalitis

机译:桥本脑病一例被误诊为病毒性脑炎

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Background: Hashimoto’s encephalopathy is a rare autoimmune syndrome characterized by various neuropsychiatric or neurological manifestations and associated with Hashimoto’s thyroiditis, responsive to steroids. Until now, misdiagnosis and delay of treatment of Hashimoto’s encephalopathy are very common because of the diversity of the symptoms.Case Report: This recent case of a 61-year-old man presented with unconsciousness, spasms and a previous misdiagnosis as viral encephalitis. Response to anti-viral and steroid therapy was unsatisfactory, but treatment with immunoglobulin combined with corticosteroid therapy achieved rapid and complete recovery.Conclusions: Any patient presenting with acute or subacute unexplained encephalopathy should be considered Hashimoto’s encephalopathy, even if the thyroid function is normal. Thyroid antibody testing should be performed because this may be the most important clue to diagnosis. As soon as the diagnosis is made, steroid therapy is the first choice. If the steroid therapy does not lead to immediate improvement, IVIG is an effective alternative treatment.
机译:背景:桥本脑病是一种罕见的自身免疫综合症,以多种神经精神病学或神经系统表现为特征,并与对类固醇有反应的桥本甲状腺炎相关。到目前为止,由于症状的多样性,桥本脑病的误诊和延误治疗非常普遍。病例报告:最近发生的一例61岁男性患有意识障碍,痉挛和先前被误诊为病毒性脑炎。对抗病毒和类固醇疗法的反应不能令人满意,但是免疫球蛋白联合皮质类固醇疗法的治疗可以快速,完全恢复。结论:即使甲状腺功能正常,任何出现急性或亚急性无法解释性脑病的患者也应视为桥本脑病。应进行甲状腺抗体检测,因为这可能是诊断的最重要线索。一旦做出诊断,类固醇疗法是首选。如果类固醇疗法不能立即改善病情,那么IVIG是一种有效的替代疗法。

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