Department of Pediatrics, Marshfield Clinic, Marshfield, Wisconsin 54449, USA.
Pediatr Neurol. 2011 Aug;45(2):132-4. doi: 10.1016/j.pediatrneurol.2011.04.002.
Steroid-responsive encephalopathy with autoimmune thyroiditis is a relatively uncommon entity in the pediatric population. Although the pathogenesis of steroid-responsive encephalopathy with autoimmune thyroiditis is uncertain, an autoimmune mechanism is suspected to be the most likely cause. Seizures of unknown etiology are a common presenting sign in the pediatric intensive care unit, and steroid-responsive encephalopathy with autoimmune thyroiditis should be considered as a possible cause of recurrent seizures. The outcome of steroid-responsive encephalopathy with autoimmune thyroiditis is variable in children, and is partly dependent on early diagnosis and the administration of intravenous steroids. Only 31 pediatric cases of steroid-responsive encephalopathy with autoimmune thyroiditis were described in the English-language literature since 1966. Very few were reported in the United States or among males. We describe a 13-year-old boy presenting with a new onset of seizures as a manifestation of steroid-responsive encephalopathy with autoimmune thyroiditis. This report presents, to the best of our knowledge, the youngest male with steroid-responsive encephalopathy with autoimmune thyroiditis, and the only reported child with other autoimmune manifestations in addition to encephalopathy.
伴有自身免疫性甲状腺炎的类固醇反应性脑病在儿科人群中相对少见。虽然伴有自身免疫性甲状腺炎的类固醇反应性脑病的发病机制尚不清楚,但怀疑自身免疫机制是最可能的原因。癫痫发作是儿科重症监护病房常见的表现,伴有自身免疫性甲状腺炎的类固醇反应性脑病应被视为复发性癫痫发作的可能原因。伴有自身免疫性甲状腺炎的类固醇反应性脑病在儿童中的预后各不相同,部分取决于早期诊断和静脉注射类固醇的应用。自 1966 年以来,仅有 31 例伴有自身免疫性甲状腺炎的类固醇反应性脑病的儿科病例在英语文献中描述。在美国或男性中报告的病例非常少。我们描述了一名 13 岁男孩,以癫痫发作为首发表现为伴有自身免疫性甲状腺炎的类固醇反应性脑病。据我们所知,这是报告的患有伴有自身免疫性甲状腺炎的类固醇反应性脑病的最年轻男性,也是除脑病外还伴有其他自身免疫表现的唯一报告儿童。