E–Pearl of the Week: Antibodies in Hashimoto Encephalopathy

May 29, 2012

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May 29, 2012

Antibodies in Hashimoto Encephalopathy

Hashimoto Encephalopathy is a highly variable clinical syndrome defined by the triad of encephalopathy, elevated antithyroid antibody levels, and clinical improvement after treatment with high dose corticosteroids. Several serum thyroid antibodies may be positive, including thyroperoxidase antibody, thyroglobulin antibody, and thyroid microsomal antibody, but they are not necessarily directly pathogenic. In the appropriate clinical context, the presence of these antibodies may be diagnostic, but approximately 10% of the general population may have elevated serum anti–thyroperoxidase antibodies. Antibody type and levels do not correlate with the severity of symptoms and may not correlate with degree of recovery after treatment.

Reference

1. Afshari M, Afshari ZS, Schuele SU. Pearls & Oy–sters: Hashimoto Encephalopathy. Neurology 2012; 78: e134–e137.

2. Castillo P, Woodruff B, Caselli R, et al. Steroid–responsive encephalopathy associated with autoimmune thyroiditis. Arch Neurol 2006;63:197–202.

Submitted by: Jennifer E. Fugate, DO

Disclosure: Dr. Fugate serves on the editorial team for the Neurology Resident and Fellow Section.

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