Matsuda Yu, Kainaga Mitsuhiro, Maeda Mizue, Kitao Hideki, Tokushige Shinichi, Uchibori Ayumi, Oishi Chizuko, Ichikawa Yaeko
Department of Neurology, Kyorin University School of Medicine, Japan.
Intern Med. 2025 Jul 10. doi: 10.2169/internalmedicine.5692-25.
Hashimoto's encephalopathy (HE) is a type of encephalopathy characterized by neuropsychiatric symptoms, high serum anti-thyroid antibody concentrations, and good responsiveness to immunotherapy. We herein report a rare case of HE with positive serum anti-NH2 terminal of α-enolase (NAE) antibodies and abnormal findings in the bilateral basal ganglia on brain magnetic resonance imaging (MRI). In cases presenting with isolated lesions in the basal ganglia, HE should not be excluded from the differential diagnosis, particularly when other causes are excluded and serum anti-thyroid antibodies are elevated. In such cases, testing for anti-NAE antibodies may aid in the diagnosis.
桥本脑病（HE）是一种以神经精神症状、血清抗甲状腺抗体浓度升高以及对免疫治疗反应良好为特征的脑病。我们在此报告一例罕见的HE病例，其血清抗α-烯醇化酶（NAE）抗体氨基末端呈阳性，且脑磁共振成像（MRI）显示双侧基底节有异常表现。对于表现为基底节孤立性病变的病例，在鉴别诊断时不应排除HE，尤其是在排除其他病因且血清抗甲状腺抗体升高的情况下。在此类病例中，检测抗NAE抗体可能有助于诊断。
