Psychiatric Symptoms due to Thyroid Disease in a Female Adolescent

The hypothalamic-pituitary-thyroid axis is involved in the production of thyroid hormone which is needed to maintain the normal functioning of various organs and systems, including the central nervous system. This study reports a case of hypothyroidism in a fifteen-year-old female adolescent who was attended for psychiatric symptoms. This case reveals the importance of evaluating thyroid function in children and adolescents with neuropsychiatric symptoms.

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Investigations into the influence of the central nervous system on the pituitary-thyroid axis

Neurology ◽

10.1212/wnl.16.12.1166 ◽

1966 ◽

Vol 16 (12) ◽

pp. 1166-1166

Author(s):

W. C. Boop ◽

M. C. ◽

J. Story

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Pituitary Thyroid Axis ◽

Thyroid Axis ◽

The Central Nervous System

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Postnatal development of brain TRH, serum TSH and thyroid hormones in the male and female rat

Acta Endocrinologica ◽

10.1530/acta.0.1120007 ◽

1986 ◽

Vol 112 (1) ◽

pp. 7-11 ◽

Cited By ~ 16

Author(s):

L. Gayo ◽

B. Bonet ◽

A. S. Herranz ◽

R. Iglesias ◽

M.J. Toro ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Thyroid Hormones ◽

Postnatal Development ◽

Female Rat ◽

Male And Female ◽

Pituitary Thyroid Axis ◽

Thyroid Axis ◽

The Central Nervous System ◽

Serum Tsh

Abstract. The postnatal development of immunoreactive TRH in the central nervous system (CNS), serum TSH and thyroid hormones was studied in both male and female normal rats. While in most structures of the CNS, TRH increased until day 20–30, serum TSH values peaked at day 15 as did T4. Significant differences were also obtained between both sexes in these parameters. These data further support the fact that pituitary-thyroid axis maturation is independent of brain TRH.

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Autoantibodies in Neuropsychiatric Systemic Lupus Erythematosus (NPSLE): Can They Be Used as Biomarkers for the Differential Diagnosis of This Disease?

Clinical Reviews in Allergy & Immunology ◽

10.1007/s12016-021-08865-2 ◽

2021 ◽

Author(s):

Elias Manca

Keyword(s):

Systemic Lupus Erythematosus ◽

Central Nervous System ◽

Nervous System ◽

Differential Diagnosis ◽

Human Body ◽

Lupus Erythematosus ◽

Neuropsychiatric Symptoms ◽

Systemic Lupus ◽

Neuropsychiatric Systemic Lupus Erythematosus ◽

The Central Nervous System

AbstractSystemic lupus erythematosus is a complex immunological disease where both environmental factors and genetic predisposition lead to the dysregulation of important immune mechanisms. Eventually, the combination of these factors leads to the production of self-reactive antibodies that can target any organ or tissue of the human body. Autoantibodies can form immune complexes responsible for both the organ damage and the most severe complications. Involvement of the central nervous system defines a subcategory of the disease, generally known with the denomination of neuropsychiatric systemic lupus erythematosus. Neuropsychiatric symptoms can range from relatively mild manifestations, such as headache, to more severe complications, such as psychosis. The evaluation of the presence of the autoantibodies in the serum of these patients is the most helpful diagnostic tool for the assessment of the disease. The scientific progresses achieved in the last decades helped researchers and physicians to discover some of autoepitopes targeted by the autoantibodies, although the majority of them have not been identified yet. Additionally, the central nervous system is full of epitopes that cannot be found elsewhere in the human body, for this reason, autoantibodies that selectively target these epitopes might be used for the differential diagnosis between patients with and without the neuropsychiatric symptoms. In this review, the most relevant data is reported with regard to mechanisms implicated in the production of autoantibodies and the most important autoantibodies found among patients with systemic lupus erythematosus with and without the neuropsychiatric manifestations.

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Neurobrucellosis mimicking primary vasculitis of the central nervous system: we should perform a metagenomic analysis of the cerebrospinal fluid prior to brain biopsy

10.5327/1516-3180.422 ◽

2021 ◽

Author(s):

Marina Barrionuevo Mathias ◽

Fernando Gatti ◽

Gustavo Bruniera ◽

Vitor Paes ◽

Gisele Sampaio Silva ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Psychiatric Symptoms ◽

Brain Mri ◽

Genetic Material ◽

Clinical Manifestations ◽

Brain Biopsy ◽

Metagenomic Analysis ◽

Normal Brain ◽

The Central Nervous System

Context Primary angiitis of the central nervous system (PACNS) is characterized by the inflammation of small and medium CNS arteries; the clinical manifestations include headache, cognitive impairment and focal neurological deficits. The gold standard test for diagnosis is brain biopsy. Neurobrucellosis is an infection associated with cattle farming, which leads to neurological and psychiatric symptoms. We report a case of neurobrucellosis mimicking PACNS. Case report Male, 32 years old, with fever, headache, dizziness and cognitive impairments for 30 days. History of stroke 2 years before, with mild sequelae right hemiparesis; investigation showed suspected intracranial dissection. On physical examination, he had apathy, preserved strength, reduced reflexes with plantar flexor responses. General laboratory tests, autoantibodies and serology were normal. Brain MRI showed deep left nucleocapsular gliosis and cerebral angiography revealed stenosis of the ICA and MCA. CSF showed 42 cells/ mm³, glucose 46 mg/dL, protein 82 mg/dL. Blood PCR was negative for Brucella. Immunophenotyping of the CSF and PET-CT excluded neoplasia. Brain biopsy was inconclusive for vasculitis. Metagenomic analysis of the CSF detected 78% of Brucella genetic material. Serum agglutination test was 1:40 for brucella. Conclusions PACNS is diagnosed by exclusion. The patient filled criteria for possible PACNS, image compatible with vascular stenosis, but inconclusive brain biopsy. Brucellosis is an endemic disease in underdeveloped countries that can present as CNS vasculitis. Metagenomic analysis allows the detection of different pathogens using a single method. The case illustrates the use of metagenomics in rare diseases characterized by vasculitis, with change in clinical outcomes and conduct.

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Liaison psychiatry in a central nervous system tumor service

Neuro-Oncology Practice ◽

10.1093/nop/npv001 ◽

2015 ◽

Vol 2 (2) ◽

pp. 88-92

Author(s):

Alex C.N. Holmes ◽

Sophia J. Adams ◽

Scott Hall ◽

Mark A. Rosenthal ◽

Katharine J. Drummond

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Neuropsychiatric Symptoms ◽

Lower Grade ◽

Central Nervous System Tumor ◽

Liaison Psychiatry ◽

Cns Tumor ◽

Treatment Information ◽

Psychological Medicine ◽

The Central Nervous System

AbstractBackgroundTumors of the central nervous system (CNS) have physical and psychological effects that commonly interact and change over time. Although well suited to addressing problems at the interface between physical and psychological medicine, the role of the consultation-liaison psychiatrist has not been previously described in the management of these patients. The purpose of this paper is to summarize the experience of psychiatry liaison attachment within a CNS tumor service and to reflect on its utility within a complex multidisciplinary environment.MethodsA retrospective file review was performed on all cases seen by a psychiatrist in a CNS tumor service over the previous 5 years. A simple thematic inductive analysis was conducted of the common problems experienced by patients and their management by the psychiatrist and within the team.ResultsFive common themes were identified: (i) facilitating adaptation to diagnosis; (ii) supporting living with lower-grade tumors; (iii) managing mental disorders; (iv) neuropsychiatric symptoms of tumor progression; and (v) grief and uncertainty in the advanced stages of illness. The capacity of the psychiatrist to understand and integrate the clinical, pathological, radiological, and treatment information, in communication with colleagues, helped address these challenges.ConclusionsPsychological challenges in CNS tumor patients have both psychological and neurological underpinnings. In our experience, the addition of a liaison psychiatrist to a CNS tumor service was efficient and effective in improving patient management and led to enhanced communication and decision-making within the team.

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Can Thyroid Hormone Analogues Be Used to Overcome Hypomyelination and Demyelination of the Central Nervous System?

EBioMedicine ◽

10.1016/j.ebiom.2017.11.004 ◽

2017 ◽

Vol 26 ◽

pp. 15-16

Author(s):

Carlie L. Cullen ◽

Kaylene M. Young

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Thyroid Hormone ◽

The Central Nervous System

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Delayed development of specific thyroid hormone-regulated events in transthyretin null mice

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.00216.2012 ◽

2013 ◽

Vol 304 (1) ◽

pp. E23-E31 ◽

Cited By ~ 20

Author(s):

Julie A. Monk ◽

Natalie A. Sims ◽

Katarzyna M. Dziegielewska ◽

Roy E. Weiss ◽

Robert G. Ramsay ◽

...

Keyword(s):

Central Nervous System ◽

Cerebrospinal Fluid ◽

Nervous System ◽

Thyroid Hormone ◽

Bone Growth ◽

Circulatory System ◽

Goblet Cells ◽

Wild Type ◽

The Central Nervous System ◽

Delayed Growth

Thyroid hormones (THs) are vital for normal postnatal development. Extracellular TH distributor proteins create an intravascular reservoir of THs. Transthyretin (TTR) is a TH distributor protein in the circulatory system and is the only TH distributor protein synthesized in the central nervous system. We investigated the phenotype of TTR null mice during development. Total and free 3′,5′,3,5-tetraiodo-l-thyronine (T4) and free 3′,3,5-triiodo-l-thyronine (T3) in plasma were significantly reduced in 14-day-old (P14) TTR null mice. TTR null mice also displayed a delayed suckling-to-weaning transition, decreased muscle mass, delayed growth, and retarded longitudinal bone growth. In addition, ileums from postnatal day 0 (P0) TTR null mice displayed disordered architecture and contained fewer goblet cells than wild type. Protein concentrations in cerebrospinal fluid from P0 and P14 TTR null mice were higher than in age-matched wild-type mice. In contrast to the current literature based on analyses of adult TTR null mice, our results demonstrate that TTR has an important and nonredundant role in influencing the development of several organs.

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