Background: Hashimoto's encephalopathy, also called steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a rare syndrome with an unknown pathogenesis. Clinical onset is insidious or acute with variable neurological symptoms. Spinal protein is elevated in most cases, but findings are non-specific in routine blood tests and on cerebral CT and EEG. The most important diagnostic clue is elevated levels of thyroid antibodies, especially anti-thyroid peroxidase antibody (anti-TPO). Administration of corticosteroids is the treatment of choice and usually results in complete recovery.
Case Report: A 66-year-old woman had experienced episodic neurological symptoms over a few weeks. On admission she demonstrated moderate aphasia, tremor and myoclonus, but no other focal neurological signs. A cerebral CT scan and routine blood tests did not provide diagnostic clues. The cerebrospinal fluid protein level was markedly elevated, and treatment with antibiotic and antiviral agents against possible encephalitis was started. However, the clinical condition did not improve. Further testing showed elevated levels of anti thyroxine peroxidase (aTPO) antibodies. Based on this finding, and after exclusion of other causes, the patient was diagnosed with Hashimoto's encephalitis. On treatment with systemic steroids, the clinical condition improved over a few days.
Conclusion: Hashimoto's encephalitis is a rare syndrome. Still, it is important to diagnose patients correctly. Treatment with steroids induces marked clinical improvement and usually confers a good prognosis.
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http://dx.doi.org/10.4045/tidsskr.09.0697 | DOI Listing |
Rev Med Chil
November 2024
Laboratorio de Biología Molecular, Hospital Base de Valdivia, Valdivia, Chile.
Encephalitis due to Epstein-Barr Virus (EBV) is a rare condition that primarily affects children and immunosuppressed patients. Diagnosing EBV encephalitis can be challenging due to its nonspecific clinical presentation and the lack of confirmatory tests. We present the case of a 66-year-old woman with a history of kidney transplantation who was admitted due to progressive subacute mental deterioration, preceded by vertigo and without fever.
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January 2025
Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, 8-1, Kawadacho, Shinjuku-ku, Tokyo 162-8666, Japan.
Superficial duodenal epithelial tumors were previously considered rare. Laparoscopic and endoscopic cooperative surgery for duodenal tumors (D-LECS) has been developed to achieve successful endoscopic treatment. Patients who have undergone living-donor liver transplantation (LDLT) may have severe abdominal adhesions, and immunosuppressive agents (IAs) may affect the degree of postoperative abdominal adhesions and wound healing, but their effects remain unclear.
View Article and Find Full Text PDFCureus
December 2024
Neurological Surgery, Hospital Central do Funchal, Funchal, PRT.
Metastases to the pituitary gland are a rare finding, with breast and lung being the most common metastases in this anatomical region. Pituitary melanoma metastases reports are thus sparse, and both diagnosis and treatment are challenging. We present the case of a 66-year-old woman with pituitary melanoma metastasis who presented with symptoms of anterior pituitary dysfunction and headache.
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January 2025
General Surgery, Cannizzaro Hospital, Catania, Italy.
In this article, we aim to demonstrate that thyroid carcinoma can metastasize to the small bowel. This case report involves a 66-year-old woman who underwent total thyroidectomy surgery in 2019, with histopathology revealing a 3A undifferentiated thyroid cancer. She presented with symptoms of bowel obstruction, including abdominal pain, nausea, and vomiting.
View Article and Find Full Text PDFEur Heart J Case Rep
January 2025
Cardiology Department, Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153-3328, USA.
Background: Immune checkpoint inhibitors (ICIs) are effective antineoplastic agents but can cause adverse effects in many organ systems. Cardiovascular toxicities include arrhythmias, myocarditis, heart failure, takotsubo syndrome, pericarditis, coronary artery disease, and vasculitis.
Case Summary: A 66-year-old woman with Stage 3C2 endometrial carcinoma presented for her second cycle of pembrolizumab, carboplatin, and paclitaxel.
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