Hashimoto’s Encephalopathy

2013 ◽  
Author(s):  
Aaron E. Miller ◽  
Teresa M. DeAngelis
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Diagnostic Testing ◽  
Therapeutic Management ◽  
Hashimoto's Thyroiditis ◽  
Hashimoto’S Encephalopathy ◽  
Clinically Normal ◽  
Unclear Etiology

Hashimoto’s encephalopathy (HE) is a rare but potentially corticosteroid responsive disorder, which should be considered in cases of encephalopathy of unclear etiology. Hashimoto’s thyroiditis usually does not accompany HE and thyroid function is generally clinically normal. In this chapter, we review the differential diagnostic suspicions for a case of encephalopathy of unclear etiology and respective aspects that raise concern for HE. In addition, we discuss the utility of diagnostic testing and options for therapeutic management.

scholarly journals The Effect of Iodine Restriction on Thyroid Function in Patients with Hypothyroidism Due to Hashimoto's Thyroiditis

2003 ◽  
Vol 44 (2) ◽  
pp. 227 ◽  
Author(s):  
Soo Jee Yoon ◽  
So Rae Choi ◽  
Dol Mi Kim ◽  
Jun Uh Kim ◽  
Kyung Wook Kim ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis

scholarly journals Serum Selenium Status and Its Interrelationship with Serum Biomarkers of Thyroid Function and Antioxidant Defense in Hashimoto’s Thyroiditis

Antioxidants ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 1070
Author(s):  
Rahim Rostami ◽  
Sarmad Nourooz-Zadeh ◽  
Afshin Mohammadi ◽  
Hamid Reza Khalkhali ◽  
Gordon Ferns ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Antioxidant Defense ◽  
Thyroid Volume ◽  
Hashimoto's Thyroiditis ◽  
Thyroid Peroxidase ◽  
Urinary Iodine Concentration ◽  
Serum Selenium ◽  
Se Deficiency ◽  
Se Status

Selenium (Se) deficiency has been implicated in the pathogenesis of Hashimoto’s thyroiditis (HT), although the available evidence is limited. The present study aimed to explore the interrelationships between serum Se status with measures of thyroid function and antioxidant defense in new cases of HT patients with hypoechogenic thyroid. HT patients (n = 49) and matched controls (n = 50) were recruited. Selenium, thyroid hormone panel, thyroid volume (TVol), glutathione (GSH), glutathione peroxidase3 (GPx3) activity, urinary iodine concentration (UIC), and urinary creatinine (Cr) were assessed. HT patients exhibited lower Se levels compared to controls (p < 0.001) with the rates of Se-deficient (<0.85 µmol/L) participants being 58.8% and 34%, respectively. Se-deficient patients exhibited higher thyroid stimulating hormone (TSH), Thyroid volume (TVol), thyroglobulin, antibody-titers, GPx3 activity and UIC/Cr compared to Se-sufficient patients (all p < 0.001). In the Se-deficient patients, inverse correlations were seen between Se-levels with TSH, TVol, and Thyroid peroxidase antibody (TPO-Ab) (all p < 0.001). This study is the first to uncover that coexisting Se-deficiency and elevated iodine in HT may enhance autoimmune reactions and accelerate the deterioration of thyroid function through oxidative stress. Our study also highlights the importance of optimal Se status in this disease, thus providing a rationale for the execution of intervention trials for the evaluation of the clinical benefits of antioxidant-status improvement in HT.

scholarly journals Thyroid function in children and adolescents with Hashimoto's thyroiditis after l-thyroxine discontinuation

2017 ◽  
Vol 6 (4) ◽  
pp. 206-212 ◽  
Author(s):  
Giorgio Radetti ◽  
Mariacarolina Salerno ◽  
Chiara Guzzetti ◽  
Marco Cappa ◽  
Andrea Corrias ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Outcome Measure ◽  
Hashimoto's Thyroiditis ◽  
Pediatric Endocrinology ◽  
Normal Range ◽  
Discontinuation Of Treatment ◽  
One Year ◽  
Serum Tsh

Objective Thyroid function may recover in patients with Hashimoto’s thyroiditis (HT). Design To investigate thyroid function and the need to resume l-thyroxine treatment after its discontinuation. Setting Nine Italian pediatric endocrinology centers. Patients 148 children and adolescents (25 m and 123 f) with HT on treatment with l-thyroxine for at least one year. Intervention and main outcome measure Treatment was discontinued in all patients, and serum TSH and fT4 concentrations were measured at the time of treatment discontinuation and then after 2, 6, 12 and 24 months. Therapy with l-thyroxine was re-instituted when TSH rose >10 U/L and/or fT4 was below the normal range. The patients were followed up when TSH concentrations were between 5 and 10 U/L and fT4 was in the normal range. Results At baseline, TSH was in the normal range in 139 patients, and was between 5 and 10 U/L in 9 patients. Treatment was re-instituted after 2 months in 37 (25.5%) patients, after 6 months in 13 patients (6.99%), after 12 months in 12 patients (8.6%), and after 24 months in an additional 3 patients (3.1%). At 24 months, 34 patients (34.3%) still required no treatment. TSH concentration >10 U/L at the time of diagnosis was the only predictive factor for the deterioration of thyroid function after l-thyroxine discontinuation. Conclusions This study confirms that not all children with HT need life-long therapy with l-thyroxine, and the discontinuation of treatment in patients with a TSH level <10 U/L at the time of diagnosis should be considered.

scholarly journals Effect of small doses of iodine on thyroid function in patients with Hashimoto's thyroiditis residing in an area of mild iodine deficiency

1998 ◽  
pp. 23-28 ◽  
Author(s):  
W Reinhardt ◽  
M Luster ◽  
KH Rudorff ◽  
C Heckmann ◽  
S Petrasch ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Function ◽  
Iodine Deficiency ◽  
Subclinical Hypothyroidism ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Volume ◽  
Treated Group ◽  
Hashimoto's Thyroiditis ◽  
Control Group ◽  
Small Doses

OBJECTIVE: Several studies have suggested that iodine may influence thyroid hormone status, and perhaps antibody production, in patients with autoimmune thyroid disease. To date, studies have been carried out using large amounts of iodine. Therefore, we evaluated the effect of small doses of iodine on thyroid function and thyroid antibody levels in euthyroid patients with Hashimoto's thyroiditis who were living in an area of mild dietary iodine deficiency. METHODS: Forty patients who tested positive for anti-thyroid (TPO) antibodies or with a moderate to severe hypoechogenic pattern on ultrasound received 250 microg potassium iodide daily for 4 months (range 2-13 months). An additional 43 patients positive for TPO antibodies or with hypoechogenicity on ultrasound served as a control group. All patients were TBII negative. RESULTS: Seven patients in the iodine-treated group developed subclinical hypothyroidism and one patient became hypothyroid. Three of the seven who were subclinically hypothyroid became euthyroid again when iodine treatment was stopped. One patient developed hyperthyroidism with a concomitant increase in TBII titre to 17 U/l, but after iodine withdrawal this patient became euthyroid again. Only one patient in the control group developed subclinical hypothyroidism during the same time period. All nine patients who developed thyroid dysfunction had reduced echogenicity on ultrasound. Four of the eight patients who developed subclinical hypothyroidism had TSH concentrations greater than 3 mU/l. In 32 patients in the iodine-treated group and 42 in the control group, no significant changes in thyroid function, antibody titres or thyroid volume were observed. CONCLUSIONS: Small amounts of supplementary iodine (250 microg) cause slight but significant changes in thyroid hormone function in predisposed individuals.

scholarly journals In vivo and in vitro effects of statins on lymphocytes in patients with Hashimoto’s thyroiditis

2005 ◽  
Vol 153 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Sevim Gullu ◽  
Rifat Emral ◽  
Mehmet Bastemir ◽  
Arthur B Parkes ◽  
John H Lazarus
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Annexin V ◽  
Normal Subjects ◽  
Hashimoto's Thyroiditis ◽  
Control Group ◽  
Cd4 Cells ◽  
Apoptotic Effects

Background: Statins have apoptotic effects on many cell types. Hashimoto’s thyroiditis (HT) is an autoimmune disease in which cell-mediated autoimmune mechanisms are pathogenetically involved. Objective: The aim of this study was to evaluate the in vivo effects of Simvastatin on thyroid function, lymphocyte subtypes and also to investigate the apoptotic effects of Simvastatin, Mevastatin, Pravastatin and Cerivastatin on lymphocytes from patients with HT. Methods: In the first part of the study, 11 patients with HT and subclinical hypothyroidism (SH) were given Simvastatin (20 mg/day) for 8 weeks. Ten patients with SH and HT served as the control group. No treatment was given to controls. Thyroid function, C-reactive protein (CRP) levels and lymphocyte subtypes of both groups were determined before the study and after 8 weeks. In the second part of the study, the apoptotic effects of statins on lymphocytes were evaluated in patients with HT (n = 10) and normal subjects (n = 10) in vitro. Apoptosis was investigated by using Annexin-V and propidium iodide. Lymphocytes from patients and controls were incubated with different concentrations of Simvastatin, Cerivastatin, Mevastatin and Pravastatin. Results: An increase in serum free tri-iodothyronine and free thyroxine levels and a decrease in TSH levels were observed (P < 0.05) with Simvastatin treatment. CD4 + cells and B lymphocytes increased whilst CD8 + cells, natural killer cells and activated T lymphocytes decreased significantly in the treatment group (P < 0.05). The CRP level of the group also decreased with Simvastatin but it did not reach significance (P = 0.057). None of parameters was found to be different from the baseline in the control group. In in vitro experiments, apoptosis was observed in CD3 + (both in CD8 + and CD4 + cells) with all statins in both patient and control samples. Mevalonate, which was used in experiments, reversed apoptosis in some but not all samples. Conclusions: The results of this study suggested that Simvastatin is an immune modulatory agent and improves thyroid function in patients with HT. This effect is probably mediated via lymphocyte apoptosis as demonstrated with in vitro experiments and is not confined to Simvastatin since Mevastatin, Pravastatin and Cerivastatin also induced apoptosis in lymphocytes.

scholarly journals Thyroid function test evolution in children with Hashimoto’s thyroiditis is closely conditioned by the biochemical picture at diagnosis

2018 ◽  
Vol 44 (1) ◽  
Author(s):  
Giuseppe Crisafulli ◽  
Romina Gallizzi ◽  
Tommaso Aversa ◽  
Giuseppina Salzano ◽  
Mariella Valenzise ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Function Test ◽  
Hashimoto's Thyroiditis ◽  
Function Test

scholarly journals Clinical Significance of Autoantibodies to Parietal Cells in Patients with Autoimmune Thyroid Diseases

Folia Medica ◽  
2013 ◽  
Vol 55 (2) ◽  
pp. 26-32 ◽  
Author(s):  
Julieta B. Gerenova ◽  
Irena M. Manolova ◽  
Vania I. Tzoneva
Keyword(s):  
Atrophic Gastritis ◽  
Clinical Significance ◽  
Thyroid Function ◽  
Hashimoto’S Thyroiditis ◽  
Thyroid Diseases ◽  
Parietal Cells ◽  
Hashimoto's Thyroiditis ◽  
Autoimmune Thyroid Diseases ◽  
Autoimmune Thyroid ◽  
Function Group

ABSTRACT Clinical significance of autoantibodies to parietal cells (PCA) in patients with autoimmune thyroid diseases (ATD) remains contradictory. AIM: To characterize the frequency of PCA in patients with ATD; to clarify the role of gender and age in PCA positivity; to analyze the association of PCA with gastric or haematologic symptoms and with the levothyroxine dose required to achieve a serum TSH level within the normal range in treated Hashimoto’s thyroiditis (HT) patients. PATIENTS AND METHODS: PCA were measured using ELISA in 137 HT patients, divided into tree subgroups according to the thyroid function: group I included subjects with normal thyroid function; group II included patients with hypothyroidism, in group III were enrolled subjects treated with levothyroxine (LT4). We also studied the PCA positivity in 14 patients with active Graves’ disease and in 23 healthy controls. RESULTS: PCA positivity was found in 51 patients with autoimmune thyroid diseases, with an overall prevalence of 33.8%. No significant differences in PCA were observed between the groups of HT patients. The frequency of PCA in both genders was similar and there were no difference depending on age. In 7.3% of HT patients in different stages of disease we found clinically relevant gastric and/or haematologic symptoms; in 70% of them PCA were positive (OR = 5.5; 95% CI: 1.2 - 28.4; p = 0.009). PCA positive hypothyroid HT patients required higher LT4 doses than PCA negative (1.46 μg/kg vs 1.24 μg/kg, p = 0.04). CONCLUSIONS: PCA may be present in different stages in HT patients; this does not depend on the severity of disease. PCA concentrations may predict symptoms of atrophic gastritis in patients with Hashimoto’s thyroiditis. PCA positive HT patients require higher replacement doses of LT4. Presence of anemia, particularly microcytic anemia, was suggestive of undiagnosed atrophic gastritis.

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