Increased prevalence of sublinical brain perfusion abnormalities in patients with autoimmune thyroiditis: evidence of Hashimoto's encephalitis?

Zettinig, Georg; Asenbaum, S.; Fueger, Barbara J.; Hofmann, Andrea; Diemling, Markus; Mittlböck, Martina; Dudczak, Robert

doi:10.1046/j.1365-2265.2003.01901.x

Cited by 66 publications

(46 citation statements)

References 40 publications

(53 reference statements)

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“…Impaired brain perfusion in patients with known autoimmune thyroiditis has been demonstrated and supports a hypothesis of cerebral involvement in autoimmune thyroiditis [7,8,9]. However, a recent study showed that a 6-month levothyroxine treatment reduces systemic inflammation in patients with Hashimoto's thyroiditis.…”

Section: Discussionmentioning

confidence: 92%

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by^99mTc-HMPAO-SPECT

et al. 2013

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Background: Hashimoto's encephalopathy (HE) is a rare immune-mediated encephalopathy associated with autoimmune Hashimoto's thyroiditis. Objectives and Methods: We report on a patient with HE and significant clinical improvement correlating with an increase in cerebral blood flow demonstrated by hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT).HMPAO-SPECT was performed with 740 MBq of technetium-99m-HMPAO. To demonstrate the improvement in regional cerebral blood flow, individual regions of interest were drawn around visually diminished HMPAO uptake, the lesion to reference region ratio was calculated and transverse section imagesand semi-quantitative measurements were performed. Results: We show a 5-year follow-up with significant clinical improvement, a 10-fold reduction in autoantibodies to thyroid peroxidase and an approximately 20% improvement in cerebral blood flow with HMPAO-SPECT. Conclusion: Adequate levothyroxine treatment achieving and maintaining euthyroidism should be considered as therapy to lower autoantibodies and improve clinical outcome in patients with Hashimoto's thyroiditis and encephalopathy.

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Section: Discussionmentioning

confidence: 92%

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by^99mTc-HMPAO-SPECT

et al. 2013

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“…One SPECT study concluded that the symptoms of HE are produced by the vasculitic disruption of the cerebral microvasculature [31]. Interestingly, two different groups of researchers performed SPECT scans in 60 euthyroid, neurologically intact patients with HT [64,91]. They found a higher than expected prevalence of cerebral hypoperfusion.…”

Section: Pathogenetic Hypothesesmentioning

confidence: 94%

The neurological disorder associated with thyroid autoimmunity

2006

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The neurological disorder associated with thyroid autoimmunity is an elusive disease that neurologists have learned to recognize in the last few years. The diagnosis is made, after excluding more common diseases, when neuropsychiatric symptoms develop in a patient with high serum concentrations of anti-thyroid antibodies. The clinical presentations of the disease and the many controversial issues surrounding the diagnosis, the pathogenesis, the role of thyroid autoantibodies, and the choice of therapy are reviewed and discussed in the light of the medical literature in English.

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“…Hadjivassiliou (29,30), thrombotic thrombocytopenic purpura (31) and ChurgStrauss syndrome (32) (2,33,34). Furthermore, SPECT studies have reported abnormal cerebral perfusion in celiac disease (35) and Hashimoto's thyroiditis with normal thyroid function (36 …”

Section: Selim and Drachman Reported That Two Of Six Patients With Anmentioning

confidence: 99%

Intravenous Immunoglobulin Therapy for Autoantibody-Positive Cerebellar Ataxia

et al. 2009

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Increased prevalence of sublinical brain perfusion abnormalities in patients with autoimmune thyroiditis: evidence of Hashimoto's encephalitis?

Cited by 66 publications

References 40 publications

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by^99mTc-HMPAO-SPECT

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by^99mTc-HMPAO-SPECT

The neurological disorder associated with thyroid autoimmunity

Intravenous Immunoglobulin Therapy for Autoantibody-Positive Cerebellar Ataxia

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Increased prevalence of sublinical brain perfusion abnormalities in patients with autoimmune thyroiditis: evidence of Hashimoto's encephalitis?

Cited by 66 publications

References 40 publications

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by99mTc-HMPAO-SPECT

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by99mTc-HMPAO-SPECT

The neurological disorder associated with thyroid autoimmunity

Intravenous Immunoglobulin Therapy for Autoantibody-Positive Cerebellar Ataxia

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Product

Resources

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Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by^99mTc-HMPAO-SPECT

Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by^99mTc-HMPAO-SPECT