一名89岁男性患有具有特殊脑脊液生物标志物特征的类固醇反应性脑病。
Steroid-responsive encephalopathy with a peculiar CSF biomarker profile in an 89-year-old man.
作者信息
Sipilä Jussi O T, Rissanen Eero, Korpela Jaana, Päivärinta Markku
机构信息
Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland.
Department of Neurology, University of Turku, Turku, Finland.
出版信息
Oxf Med Case Reports. 2018 Sep 24;2018(10):omy073. doi: 10.1093/omcr/omy073. eCollection 2018 Oct.
Being treatable, steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), or Hashimoto's encephalopathy, should be distinguished from untreatable conditions. Our patient was a previously healthy 89-year-old man, who presented with cognitive and balance deterioration over several months. His cerebrospinal fluid (CSF) examination was positive for protein 14-3-3 but no other test suggested Creutzfeldt-Jacob disease. His condition improved markedly, although not fully, with intravenous corticosteroids. In control CSF sampling, protein 14-3-3 was negative but a biomarker signature consistent with Alzheimer's disease was observed. SREAT should be considered also in the very elderly in case of subacute encephalopathy.
可治疗的自身免疫性甲状腺炎相关性类固醇反应性脑病（SREAT），即桥本脑病，应与不可治疗的疾病相区分。我们的患者是一位既往健康的89岁男性，在数月内出现认知和平衡功能恶化。他的脑脊液（CSF）检查显示14-3-3蛋白呈阳性，但没有其他检查提示克雅氏病。静脉注射皮质类固醇后，他的病情虽未完全恢复，但有明显改善。在对照CSF采样中，14-3-3蛋白呈阴性，但观察到与阿尔茨海默病一致的生物标志物特征。对于非常年老的患者出现亚急性脑病的情况，也应考虑SREAT。
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