Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.

Hdl Handle:
http://hdl.handle.net/10147/207688
Title:
Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.
Authors:
Tamagno, Gianluca; Celik, Yahya; Simo, Rafael; Dihne, Marcel; Kimura, Kazumi; Gelosa, Giorgio; Lee, Byung I; Hommet, Caroline; Murialdo, Giovanni
Affiliation:
Department of Endocrinology and Diabetes Mellitus, St Vincent's University, Hospital, University College Dublin, Dublin, Ireland. gianluca.tamagno@ucd.ie
Citation:
BMC Neurol. 2010 Apr 28;10:27.
Journal:
BMC neurology
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207688
DOI:
10.1186/1471-2377-10-27
PubMed ID:
20426819
Abstract:
BACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto's thyroiditis (HT), although fourteen EAATD patients with Graves' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.
Language:
eng
MeSH:
Adolescent; Adrenal Cortex Hormones/therapeutic use; Adult; Aged; Autoantibodies/blood/immunology; Child; Electroencephalography/methods; Encephalitis/blood/*complications/drug therapy; Female; Follow-Up Studies; Graves Disease/*complications/drug therapy; Humans; Male; Middle Aged; Thyroiditis, Autoimmune/*complications/drug therapy; Treatment Outcome; Young Adult
ISSN:
1471-2377 (Electronic); 1471-2377 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorTamagno, Gianlucaen_GB
dc.contributor.authorCelik, Yahyaen_GB
dc.contributor.authorSimo, Rafaelen_GB
dc.contributor.authorDihne, Marcelen_GB
dc.contributor.authorKimura, Kazumien_GB
dc.contributor.authorGelosa, Giorgioen_GB
dc.contributor.authorLee, Byung Ien_GB
dc.contributor.authorHommet, Carolineen_GB
dc.contributor.authorMurialdo, Giovannien_GB
dc.date.accessioned2012-02-01T10:34:59Z-
dc.date.available2012-02-01T10:34:59Z-
dc.date.issued2012-02-01T10:34:59Z-
dc.identifier.citationBMC Neurol. 2010 Apr 28;10:27.en_GB
dc.identifier.issn1471-2377 (Electronic)en_GB
dc.identifier.issn1471-2377 (Linking)en_GB
dc.identifier.pmid20426819en_GB
dc.identifier.doi10.1186/1471-2377-10-27en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207688-
dc.description.abstractBACKGROUND: The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto's thyroiditis (HT), although fourteen EAATD patients with Graves' disease (GD) have been also reported. METHODS: We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term. RESULTS: Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management. CONCLUSIONS: GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdrenal Cortex Hormones/therapeutic useen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAutoantibodies/blood/immunologyen_GB
dc.subject.meshChilden_GB
dc.subject.meshElectroencephalography/methodsen_GB
dc.subject.meshEncephalitis/blood/*complications/drug therapyen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshGraves Disease/*complications/drug therapyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshThyroiditis, Autoimmune/*complications/drug therapyen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.subject.meshYoung Adulten_GB
dc.titleEncephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes.en_GB
dc.contributor.departmentDepartment of Endocrinology and Diabetes Mellitus, St Vincent's University, Hospital, University College Dublin, Dublin, Ireland. gianluca.tamagno@ucd.ieen_GB
dc.identifier.journalBMC neurologyen_GB
dc.description.provinceLeinster-

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