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Adolescent Psychiatry

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ISSN (Print): 2210-6766
ISSN (Online): 2210-6774

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Case Report

Hashimoto’s Encephalopathy Presenting as Recurrent Brief Psychotic Episodes in a 13-Year-Old Girl: A Case Report

Author(s): Nalakath A. Uvais*

Volume 9, Issue 3, 2019

Page: [241 - 243] Pages: 3

DOI: 10.2174/2210676609666190415125923

Abstract

Background: Hashimoto’s encephalopathy (HE) is a debilitating manifestation of an autoimmune reaction against the thyroid that rarely can present with prominent psychiatric symptoms. It is often under-diagnosed primarily due to its variety of symptoms as well as a lack of definitive diagnostic criteria.

Methods: We report the case of a 13-year-old girl who was diagnosed with HE after presenting with recurrent and severe psychosis with fever and a thyroidopathy. The patient had prominent visual hallucinations and paranoid delusions. Between episodes, the patient did not show evidence of psychiatric symptoms. This patient struggled with several incorrect diagnoses and treatments for two years before the correct diagnosis of HE was made and displayed marked improvement upon corticosteroid administration.

Discussion: This case illustrates the importance of increasing awareness of HE as well as including HE in a differential diagnosis when paediatric patients present with psychosis and concurrent thyroidopathy.

Keywords: Thyroid, anti-TPO, psychosis, immunotherapy, paranoid delusions, visual hallucinations.

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Arrojo, M., Perez-Rodriguez, M.M., Mota, M., Moreira, R., Azevedo, A., Oliveira, A. . . .Baca-Garcia, E. (2007) Psychiatric presentation of Hashimoto’s encephalopathy. Psychosomatic Medicine., 69, 200-201.
Brain, L., Jellinek, E.H., Ball, K. (1966). Hashimoto’s disease and encephalopathy. Lancet, 2, 512-514.
Brownlie, B.E., Rae, A.M., Walshe, J.W., Wells, J.E. (2000). Psychoses associated with thyrotoxicosis - ‘thyrotoxic psychosis’. A report of 18 cases, with statistical analysis of incidence. European Journal of Endocrinology., 142(5), 438-444.
Castillo, P., Woodruff, B., Caselli, R. (2006). Steroid-responsive encephalopathy associated with autoimmune thyroiditis. Archives of. Neurology, 63(2), 197-202.
Chaudhuri, A., Behan, P.O. (2003). The clinical spectrum, diagnosis, pathogenesis and treatment of Hashimoto’s encephalopathy (recurrent acute disseminated encephalomyelitis). Current. Medicinal Chemistry., 10, 1945-1953.
Das, S., Doval, N., & Moun, V. (2017). Autoimmune thyroiditis presenting as psychosis. Shanghai Archives of Psychiatry, 29(3), 174-176.
Ferracci, F., Bertiato, G., & Moretto, G. (2004). Hashimoto’s encephalopathy: Epidemiologic data and pathogenetic considerations. Journal of the Neurological Sciences,, 217, 165-168.
González, M.M. (2014). Antithyroid psychosis. Archives of Medicine, 6(2), 1.
[http://dx.doi.org/10.3823/114]
Haider, A.S., Alam, M., Adetutu, E., Thakur, R., Gottlich, C., DeBacker, D.L., & Marks, L. (2016). Autoimmune schizophrenia? Psychiatric manifestations of Hashimoto’s encephalitis. Cureus, 8(7) e672
[http://dx.doi.org/10.7759/cureus.672]
Latinville, D., Bernardi, O., Cougoule, J.P., Bioulac, B., Henry, P., Loiseau, P., Mauriac, L. (1985). Hashimoto’s thyroiditis and myoclonic encephalopathy. Pathogenic hypothesis. Revue. Neurologique (Paris), 141, 55-58.
Lee, J., Yu, H. J. (2018). Hashimoto encephalopathy in pediatric patients: Homogeneity in clinical presentation and heterogeneity in antibody titers. Brain & Development, 40(1), 42-48.
[http://dx.doi.org/10.1016/j.braindev.2017.07.008.]
Seipelt, M., Zerr, I., Nau, R., Mollenhauer, B., Kropp, S., Steinhoff, B.J., ..Poser, S. (1999). Hashimoto’s encephalitis as a differential diagnosis of Creutzfeld-Jakob disease. Journal of. Neurology. Neurosurgery and Psychiatry, 66, 172-176.

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