Hashimoto encephalopathy in the 21st century

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorMATTOZZI, Simone
dc.contributor.authorSABATER, Lidia
dc.contributor.authorESCUDERO, Domingo
dc.contributor.authorARINO, Helena
dc.contributor.authorARMANGUE, Thais
dc.contributor.authorSIMABUKURO, Mateus
dc.contributor.authorIIZUKA, Takahiro
dc.contributor.authorHARA, Makoto
dc.contributor.authorSAIZ, Albert
dc.contributor.authorSOTGIU, Stefano
dc.contributor.authorDALMAU, Josep
dc.contributor.authorGRAUS, Francesc
dc.date.accessioned2020-06-01T15:00:07Z
dc.date.available2020-06-01T15:00:07Z
dc.date.issued2020
dc.description.abstractObjectiveTo report the presenting syndromes and to determine whether pretreatment criteria of Hashimoto encephalopathy (HE) predict response to steroids.MethodsWe assessed symptoms and steroid responsiveness in 24 patients with pretreatment criteria of HE, including (1) subacute onset of cognitive impairment, psychiatric symptoms, or seizures; (2) euthyroid status or mild hypothyroidism; (3) serum thyroid peroxidase antibodies (TPOAb) >200 IU/mL; (4) absent neuronal antibodies in serum/CSF; and (5) no other etiologies. Additional studies included determination of TPOAb (>200 IU/mL) in 74 patients with criteria of possible autoimmune encephalitis (AE) without neuronal antibodies and 205 patients with different neuroimmunologic diseases, psychosis, or new-onset refractory status epilepticus (NORSE). Serum antibodies to the amino (Nu Eta 2)-terminal of alpha -enolase (NH2-alpha -enolaseAb) were examined in the indicated 24 patients and 13 controls.ResultsThe 24 patients (14 women) with suspected HE had a median age of 48 years (range 8-79 years). Four syndromes were identified: psychiatric (7, 29%), encephalopathy (7, 29%), NORSE-like (6, 25%), and limbic encephalitis (4, 17%). Only 6 of 19 (31.6%) patients completely responded to steroids. The frequency of TPOAb in the 74 patients with possible AE (6 of 74, 8.1%) was similar to that of the 205 controls (17 of 205, 8.2%; p = 0.84). NH2-alpha -enolaseAb were identified in 1 of 24 suspected HE cases and 1 of 13 controls.ConclusionCurrent pretreatment criteria of HE do not predict steroid responsiveness. The detection of TPOAb across all control groups reveals their poor disease-specificity. NH2-alpha -enolaseAb did not help in the diagnosis of HE. These findings imply a redefinition of HE that requires a systematic exclusion of antibody-mediated encephalitis.eng
dc.description.indexMEDLINEeng
dc.description.sponsorshipFondo de Investigaciones Sanitarias, FEDER, Spain [FIS 15/00377, FIS 14/00203, FIS 18/00067]
dc.description.sponsorshipNIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [RO1NS077851]
dc.description.sponsorshipFundacio CellexFoundation CELLEX
dc.identifier.citationNEUROLOGY, v.94, n.2, p.E217-E224, 2020
dc.identifier.doi10.1212/WNL.0000000000008785
dc.identifier.eissn1526-632X
dc.identifier.issn0028-3878
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/36201
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINSeng
dc.relation.ispartofNeurology
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
dc.subject.othercerebellar-ataxiaeng
dc.subject.otheralpha-enolaseeng
dc.subject.otherantibodieseng
dc.subject.otherautoantibodieseng
dc.subject.otherthyroiditiseng
dc.subject.otherdiagnosiseng
dc.subject.otheroutcomeseng
dc.subject.wosClinical Neurologyeng
dc.titleHashimoto encephalopathy in the 21st centuryeng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryEspanha
hcfmusp.affiliation.countryJapão
hcfmusp.affiliation.countryisoit
hcfmusp.affiliation.countryisoes
hcfmusp.affiliation.countryisojp
hcfmusp.author.externalMATTOZZI, Simone:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain; Univ Sassari, Dept Med Surg & Expt Med, Sassari, Italy
hcfmusp.author.externalSABATER, Lidia:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain
hcfmusp.author.externalESCUDERO, Domingo:Univ Barcelona, St Joan Deu Childrens Hosp, Hosp Clin, Serv Neurol, Barcelona, Spain
hcfmusp.author.externalARINO, Helena:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain
hcfmusp.author.externalARMANGUE, Thais:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain; Univ Barcelona, St Joan Deu Childrens Hosp, Dept Neurol, Pediat Neuroimmunol Unit, Barcelona, Spain
hcfmusp.author.externalIIZUKA, Takahiro:Kitasato Univ, Sch Med, Dept Neurol, Sagamihara, Kanagawa, Japan
hcfmusp.author.externalHARA, Makoto:Nihon Univ, Sch Med, Dept Med, Div Neurol, Tokyo, Japan
hcfmusp.author.externalSAIZ, Albert:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain; Univ Barcelona, St Joan Deu Childrens Hosp, Hosp Clin, Serv Neurol, Barcelona, Spain
hcfmusp.author.externalSOTGIU, Stefano:Univ Sassari, Dept Med Surg & Expt Med, Sassari, Italy
hcfmusp.author.externalDALMAU, Josep:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain; Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA; Inst Catalana Recerca & Estudis Avancats, Barcelona, Spain
hcfmusp.author.externalGRAUS, Francesc:Inst Invest Biomed August Pi & Sunyer, Neuroimmunol Program, Barcelona, Spain
hcfmusp.citation.scopus75
hcfmusp.contributor.author-fmusphcMATEUS MISTIERI SIMABUKURO
hcfmusp.description.beginpageE217
hcfmusp.description.endpageE224
hcfmusp.description.issue2
hcfmusp.description.volume94
hcfmusp.origemWOS
hcfmusp.origem.pubmed31882532
hcfmusp.origem.scopus2-s2.0-85077780189
hcfmusp.origem.wosWOS:000525668500025
hcfmusp.publisher.cityPHILADELPHIAeng
hcfmusp.publisher.countryUSAeng
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