Brain hypoperfusion on Tc-99m-ethylene dicysteine diethyl ester single-photon emission computed tomography in Hashimoto's encephalopathy

We present a 17-year-old female, previously diagnosed of autoimmune hyperthyroidism who had an acute neurological episode and presented high antithyroid antibodies titers, cerebral spinal fluid and electroencephalogram changes. Tc-99m ethylene dicysteine diethyl ester brain single-photon emission computed tomography (SPECT) showed global and patchy hypoperfusion. With glucocorticoid therapy, clinical symptoms disappeared; there was a decrease in antithyroid antibody levels and repeat brain SPECT revealed improvement of perfusion.

[1]  G. Tamburini,et al.  Affective psychosis, Hashimoto's thyroiditis, and brain perfusion abnormalities: case report , 2007, Clinical practice and epidemiology in mental health : CP & EMH.

[2]  F. Ferracci,et al.  The neurological disorder associated with thyroid autoimmunity , 2006, Journal of Neurology.

[3]  M. Piga,et al.  Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis , 2004, European Journal of Nuclear Medicine and Molecular Imaging.

[4]  A. Lteif,et al.  Steroid-responsive encephalopathy associated with Hashimoto's thyroiditis in an adolescent with chronic hallucinations and depression: case report and review. , 2003, Pediatrics.

[5]  U. Misra,et al.  Hashimoto's encephalopathy: clinical, SPECT and neurophysiological data. , 2003, QJM : monthly journal of the Association of Physicians.

[6]  L. Rowland,et al.  Hashimoto encephalopathy: syndrome or myth? , 2003 .

[7]  J. Pellock,et al.  Encephalopathy as the Presenting Symptom of Hashimoto's Thyroiditis , 2000, Journal of child neurology.

[8]  C. Forchetti,et al.  Autoimmune thyroiditis and a rapidly progressive dementia: Global hypoperfusion on SPECT scanning suggests a possible mechanism , 1997, Neurology.

[9]  M. Walterfang,et al.  Hashimoto’s Encephalopathy , 2007, CNS drugs.

[10]  Giovanni Federspil,et al.  Clinical and diagnostic aspects of encephalopathy associated with autoimmune thyroid disease (or Hashimoto’s encephalopathy) , 2006, Internal and emergency medicine.