Ghosh Ritwik, Chatterjee Subhankar, Roy Devlina, Dubey Souvik, Ray Biman Kanti
Department of General Medicine, Burdwan Medical College and Hospital, Burdwan, West Bengal, India.
Department of General Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
J Family Med Prim Care. 2020 Mar 26;9(3):1765-1767. doi: 10.4103/jfmpc.jfmpc_1197_19. eCollection 2020 Mar.
Hashimoto's Encephalopathy (HE), also known as steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is a proteiform disorder known for its wide spectrum of presentations from subtle neuropsychiatric manifestations, movement disorders, seizures, stroke-like episodes to coma. Here, we report a case of HE which initially masqueraded as bipolar affective disorder (BPAD) and ultimately progressed to generalized tonic clonic seizures and coma. Although SREAT is characterized by exquisite responsive to steroid, in our case it was unresponsive to pulse methylprednisolone therapy. Rapid recovery was noted with intravenous immunoglobulin (IVIG) therapy. This case was also peculiar for its association with non-sydnromic retinitis pigmetosa (RP). To the best of our knowledge, this was the first reported case of HE which was associated with RP.
桥本脑病（HE），也称为与自身免疫性甲状腺炎相关的类固醇反应性脑病（SREAT），是一种症状多样的疾病，其表现范围广泛，从轻微的神经精神症状、运动障碍、癫痫发作、类中风发作到昏迷。在此，我们报告一例最初伪装为双相情感障碍（BPAD），最终发展为全身强直阵挛性发作和昏迷的HE病例。尽管SREAT的特点是对类固醇有良好反应，但在我们的病例中，患者对甲基强的松龙冲击疗法无反应。静脉注射免疫球蛋白（IVIG）治疗后患者迅速康复。该病例还因其与非综合征性视网膜色素变性（RP）相关而显得特殊。据我们所知，这是首例报道的与RP相关的HE病例。
