Department of Paediatrics, University Medical Centre Groningen, P.O. Box 30.001, 9700, RB, Groningen, the Netherlands.
Department of Paediatrics, Medical Centre Leeuwarden, P.O. Box 888, 8901, BR, Leeuwarden, the Netherlands.
Eur J Paediatr Neurol. 2021 May;32:122-127. doi: 10.1016/j.ejpn.2021.04.006. Epub 2021 Apr 30.
Hashimoto's encephalopathy, also known as steroid responsive encephalopathy, is associated with thyroid antibodies (SREAT) and is a rare but serious form of encephalopathy. In this paper, we describe the signs, symptoms, outcome, and treatments as noted in the case reports reviewed.
We searched PubMed, Embase, and the Cochrane library for articles in which cases of Hashimoto's encephalopathy were described. The case description had to include the diagnosis, age, sex, presenting symptoms, and diagnostic tests.
We retrieved 360 articles and 65 fulfilled the inclusion criteria. These articles gave reports of 100 cases, with a mean age of 10.9 (range 2.8-19), 78 of whom were female. Epilepsy (79) - including epileptic state [24] - behavioural problems [36], hallucinations [21], headache [21], and decline in school performance [19] were most often reported. Antithyroid peroxidase (aTPO) was reported elevated in all patients. Most children [70] recovered fully, however 16 had late sequelae, mostly epilepsy. Therapies used include steroids, intravenous gammaglobulines, and cytostatics.
Epilepsy, behavioural problems, decline in school performance, and hallucinations are frequent symptoms of Hashimoto's encephalopathy. Steroids are the basis of treatment, although other immunomodulatory drugs seem to be successful. About one in ten children will experience late sequelae. In any child with unexplained neurological, psychiatric, or psychological dysfunction, serum anti-thyroidperoxidase (aTPO) should be determined.
桥本脑病，又称激素反应性脑病，与甲状腺抗体（SREAT）有关，是一种罕见但严重的脑病。本文描述了我们从已审查的病例报告中注意到的该疾病的体征、症状、结果和治疗方法。
我们在 PubMed、Embase 和 Cochrane 图书馆中搜索了描述桥本脑病病例的文章。病例描述必须包括诊断、年龄、性别、表现症状和诊断测试。
我们检索到 360 篇文章，其中 65 篇符合纳入标准。这些文章报告了 100 例病例，平均年龄为 10.9 岁（范围 2.8-19 岁），其中 78 例为女性。最常报告的症状包括癫痫（79 例），包括癫痫状态[24]、行为问题[36]、幻觉[21]、头痛[21]和学习成绩下降[19]。所有患者均报告抗甲状腺过氧化物酶（aTPO）升高。大多数儿童[70]完全康复，但 16 例有迟发性后遗症，主要为癫痫。使用的治疗方法包括类固醇、静脉注射免疫球蛋白和细胞毒药物。
癫痫、行为问题、学习成绩下降和幻觉是桥本脑病的常见症状。类固醇是治疗的基础，尽管其他免疫调节药物似乎也有效。大约十分之一的儿童会出现迟发性后遗症。在任何有不明原因的神经、精神或心理功能障碍的儿童中，都应测定血清抗甲状腺过氧化物酶（aTPO）。
