Pituitary-Thyroid Dysfunction in a Hashimoto’s Encephalopathy Patient

The pathogenesis of Hashimoto’s encephalopathy has not been clearly elucidated and involvement of autoimmune damage has been proposed. We report a 23-year-old man who was emergently hospitalized for paroxysmal syncope and involuntary tremor with normal physical examination except for low heart rate. The patient was characterized by neurological symptoms, mild hypothyroidism, enlarged pituitary gland and extremely elevated thyrotropin, which all were reversed with levothyroxine alone. The case indicated that the pituitary-thyroid dysfunction may play a role in the pathogenesis of Hashimoto’s encephalopathy, hence, evaluation of pituitary gland should be recommended in diagnosis and treatment of Hashimoto’s encephalopathy.

Effect of Qilongtoutong granule on calcitonin gene-related peptide,beta-endorphin, serotonin, dopamine, and noradrenalin in migraine model rats and mice

OBJECTIVE: To study the effect of Qilongtoutong granule(QLTT) on plasma calcitonin gene-related peptide(CGRP), beta-endorphin(β-EP), 5-HT, dopamine(DA), noradrenalin(NE), and blood viscosity in migraine model rats and mice.METHODS: Both the acute blood stasis model group and nitroglycerin-induced migraine model group included 60 Sprague-Dawley rats. The reserpine-reduced model group had 60 Kunming mice.Rats from each test were grouped into normal control group, model group, Zhengtian pill(ZTP)group, and high, moderate, or low-dose QLTT groups. In the acute blood stasis model test, after gavage for 7 days, rats were given 0.8 mL/kg adrenaline hydrochloride subcutaneously twice, and kept in ice water for 5 min. After fasting for 12 h,rats were anesthetized and blood samples were col-lected for detection of blood viscosity. In the nitroglycerin-induced migraine group, after gavage for7 days, rats were intraperitoneally injected nitroglycerin(10 mg/kg), and 4 h later, blood samples were collected from postcava for measuring the plasma CGRP and β-EP levels. In the reserpine-reduced model test, except the normal control group, mice were administered reserpine(0.25 mg/kg, i.h.) for 9 days. Mice received intragastric administration from the third day to the ninth day. One hour after the last gavage, blood and brain tissue samples were obtained. Then, blood clotting time and the contents of neurotransmitters were determined.RESULTS: QLTT-(3.6, 1.8, and 0.9 g/kg) and ZTP-treated rats had lower blood viscosity than that in model rats under different shear rates(P<0.01). QLTT-(3.6, 1.8 g/kg) and ZTP-treated rats had significantly lower plasma CGRP levels and higher plasma β-EP levels than those in model rats(P<0.01). QLTT treatment at dose of 0.9 g/kg had lower plasma CGRP levels as well(P<0.05). QLTT-(5.2,2.6 g/kg) and ZTP-treated mice had longer blood clotting time than that in model mice(P<0.01).QLTT-(2.6 g/kg) and ZTP-treated mice had higher plasma serotonin(5-HT) levels than those in model mice(P<0.05).CONCLUSION: QLTT-treated animals had lower plasma CGRP level, higher plasma β-EP, 5-HT, higher brain tissue 5-HT, NE, DA levels, and lower blood viscosity than those in the migraine model animals.