Hashimoto’s encephalopathy(HE)is a rare form of reversible encephalopathy characterized by the presence of anti-thyroid antibodies in serum and/or cerebrospinal fl uid.The syndrome is more common in women and the pre...Hashimoto’s encephalopathy(HE)is a rare form of reversible encephalopathy characterized by the presence of anti-thyroid antibodies in serum and/or cerebrospinal fl uid.The syndrome is more common in women and the presentation varies considerably.Here,we report a case of an elderly male with a history of Hashimoto’s thyroiditis,presenting with acute cognitive decline.A diagnosis of HE was established based on the presence of antithyroid antibodies in the serum,diffuse electroencephalography changes and lack of an alternative explanation.The patient promptly responded to steroids and was discharged on the 8th day of admission.We suggest that an assessment of thyroid antibodies should be included in anyone presenting with acute cognitive decline in the absence of alternative explanation.展开更多
BACKGROUND The incidence of toxic diffuse goiter(Graves’disease)is higher in adolescents and preschool-aged children,with an upward trend.The incidence at 6–13 years of age is approximately 11.0%,and the incidences ...BACKGROUND The incidence of toxic diffuse goiter(Graves’disease)is higher in adolescents and preschool-aged children,with an upward trend.The incidence at 6–13 years of age is approximately 11.0%,and the incidences in men and women are 7.8%and 14.3%,respectively.AIM To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter(Graves’disease)in children and its effect on serum anti-thyroglobulin antibody(TRAb)and anti-thyroid peroxidase antibody(TPOAb).METHODS A total of 103 children with Graves’disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group(15-20 mg methimazole orally given to children)and a combined group(50μg selenium added on the basis of traditional treatment)according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb,TPOAb,free thyroxine(FT4)and inflammatory factor levels before and after treatment.The time taken for FT4 to return to normal was compared between the two groups.RESULTS Treatment was significantly more effective in the combined group than in the traditional group(P<0.05).The thyroid volumes of the children in the two groups was measured before and after treatment.Thyroid volume decreased significantly after treatment in both groups,and the thyroid volume was significantly lower in the combined group than in the traditional group(P<0.05).The serum levels of interleukin-6(IL-6),IL-8,TRAb,TPOAb and FT4 in the two groups were detected before and after treatment.The levels of IL-6,IL-8,TRAb,TPOAb and FT4 were significantly lower in the combined group than in the traditional group(P<0.05).Follow-up of the children in the two groups showed that compared with the traditional group,it took less time for children in the combined group to return to the normal level(P<0.05).CONCLUSION Methimazole combined with selenium can effectively treat Graves’disease in children,reduce the expression of TRAb,TPOAb,FT4 and inflammatory factors,and improve the curative effect.Thus,the combined treatment warrants further clinical research.展开更多
Hashimoto's encephalopathy(HE)is a rare disease with unknown pathogenesis.An epileptic seizure is reported in association with HE.Here,the author reported an 18-year-old girl with a history of hyperthyroidism for ...Hashimoto's encephalopathy(HE)is a rare disease with unknown pathogenesis.An epileptic seizure is reported in association with HE.Here,the author reported an 18-year-old girl with a history of hyperthyroidism for one year.She was admitted to the hospital due to status epilepticus.Serum thyroid function test showed that the concentration of anti-thyroid peroxidase antibodies and thyroglobulin antibody were significantly elevated.Brain magnetic resonance imaging showed that multiple abnormalities varied from bilateral frontal,parietal,occipital-temporal lobe to cerebellum hemisphere.The patient’s symptoms were significantly relieved after methylprednisolone therapy.At 3-month follow-up visits,she had been symptom free.HE is a diagnosis of exclusion and should be considered when evaluating a patient with cognitive dysfunction and high titers of anti-thyroid antibodies as it responds dramatically to steroids.展开更多
文摘Hashimoto’s encephalopathy(HE)is a rare form of reversible encephalopathy characterized by the presence of anti-thyroid antibodies in serum and/or cerebrospinal fl uid.The syndrome is more common in women and the presentation varies considerably.Here,we report a case of an elderly male with a history of Hashimoto’s thyroiditis,presenting with acute cognitive decline.A diagnosis of HE was established based on the presence of antithyroid antibodies in the serum,diffuse electroencephalography changes and lack of an alternative explanation.The patient promptly responded to steroids and was discharged on the 8th day of admission.We suggest that an assessment of thyroid antibodies should be included in anyone presenting with acute cognitive decline in the absence of alternative explanation.
文摘BACKGROUND The incidence of toxic diffuse goiter(Graves’disease)is higher in adolescents and preschool-aged children,with an upward trend.The incidence at 6–13 years of age is approximately 11.0%,and the incidences in men and women are 7.8%and 14.3%,respectively.AIM To explore the clinical effect of methimazole combined with selenium in the treatment of toxic diffuse goiter(Graves’disease)in children and its effect on serum anti-thyroglobulin antibody(TRAb)and anti-thyroid peroxidase antibody(TPOAb).METHODS A total of 103 children with Graves’disease treated in our hospital from January 2018 to June 2021 were divided into a traditional group and a combined group(15-20 mg methimazole orally given to children)and a combined group(50μg selenium added on the basis of traditional treatment)according to different treatment methods to explore the therapeutic effects of the two methods and to observe the changes in thyroid volume and serum TRAb,TPOAb,free thyroxine(FT4)and inflammatory factor levels before and after treatment.The time taken for FT4 to return to normal was compared between the two groups.RESULTS Treatment was significantly more effective in the combined group than in the traditional group(P<0.05).The thyroid volumes of the children in the two groups was measured before and after treatment.Thyroid volume decreased significantly after treatment in both groups,and the thyroid volume was significantly lower in the combined group than in the traditional group(P<0.05).The serum levels of interleukin-6(IL-6),IL-8,TRAb,TPOAb and FT4 in the two groups were detected before and after treatment.The levels of IL-6,IL-8,TRAb,TPOAb and FT4 were significantly lower in the combined group than in the traditional group(P<0.05).Follow-up of the children in the two groups showed that compared with the traditional group,it took less time for children in the combined group to return to the normal level(P<0.05).CONCLUSION Methimazole combined with selenium can effectively treat Graves’disease in children,reduce the expression of TRAb,TPOAb,FT4 and inflammatory factors,and improve the curative effect.Thus,the combined treatment warrants further clinical research.
基金supported by the grants from the Fujian Province Natural Science Fund(2013J01275,2014J01401).
文摘Hashimoto's encephalopathy(HE)is a rare disease with unknown pathogenesis.An epileptic seizure is reported in association with HE.Here,the author reported an 18-year-old girl with a history of hyperthyroidism for one year.She was admitted to the hospital due to status epilepticus.Serum thyroid function test showed that the concentration of anti-thyroid peroxidase antibodies and thyroglobulin antibody were significantly elevated.Brain magnetic resonance imaging showed that multiple abnormalities varied from bilateral frontal,parietal,occipital-temporal lobe to cerebellum hemisphere.The patient’s symptoms were significantly relieved after methylprednisolone therapy.At 3-month follow-up visits,she had been symptom free.HE is a diagnosis of exclusion and should be considered when evaluating a patient with cognitive dysfunction and high titers of anti-thyroid antibodies as it responds dramatically to steroids.
