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

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    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
    Issue Date
    2012-02-01T10:34:59Z
    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
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    Citation
    BMC Neurol. 2010 Apr 28;10:27.
    Journal
    BMC neurology
    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
    ISSN
    1471-2377 (Electronic)
    1471-2377 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1186/1471-2377-10-27
    Scopus Count
    Collections
    St. Vincent's University Hospital

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