Hashimoto's encephalopathy mimicking Creutzfeldt-Jakob disease

J Clin Neurosci. 2017 Jan:35:72-73. doi: 10.1016/j.jocn.2016.09.019. Epub 2016 Oct 13.

Abstract

Hashimoto's encephalopathy is a rare, imprecisely defined autoimmune neurologic syndrome associated with Hashimoto's thyroiditis that normally responds to corticosteroids. Here, we describe the case of a 55-year-old woman who presented with subacute cognitive decline and ataxia. Neoplastic, paraneoplastic, infectious, and metabolic etiologies were ruled out. Anti-TPO antibody level was markedly elevated at 966U/mL. After one month of 60mg/day of oral prednisone, she felt back to baseline and her Montreal Cognitive Assessment dramatically improved. Physicians should strongly consider this uncommon diagnosis in patients with rapid cognitive decline and no other clear etiology.

Keywords: Ataxia; Cognition; Corticosteroids; Creutzfeldt-Jakob disease; Dementia; Hashimoto’s encephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Ataxia / etiology
  • Ataxia / psychology
  • Cognition Disorders / etiology
  • Cognition Disorders / psychology
  • Confusion / etiology
  • Confusion / psychology
  • Creutzfeldt-Jakob Syndrome / diagnosis
  • Creutzfeldt-Jakob Syndrome / psychology*
  • Diagnosis, Differential
  • Encephalitis / diagnosis
  • Encephalitis / drug therapy*
  • Encephalitis / psychology*
  • Female
  • Hashimoto Disease / diagnosis
  • Hashimoto Disease / drug therapy*
  • Hashimoto Disease / psychology*
  • Humans
  • Middle Aged
  • Neuropsychological Tests
  • Prednisone / therapeutic use

Substances

  • Anti-Inflammatory Agents
  • Prednisone

Supplementary concepts

  • Hashimoto's encephalitis