Hashimoto's encephalopathy presenting with bipolar affective disorder.
OBJECTIVE
We report on a rare case of Hashimoto's encephalopathy associated with a bipolar affective disorder.


METHODS
A 32-year-old woman presented with a bipolar affective disorder and Hashimoto's thyroiditis. Neurological investigations (magnetic resonance imaging of the brain and cerebrospinal fluid) did not reveal any pathological findings except for a pathological electroencephalogram (EEG). Despite consequent antidepressant treatment, the patient remitted only in conjunction with normalization of the EEG after short-term treatment with high doses of prednisolone.


CONCLUSIONS
In treatment resistant courses of disorders, the thorough clinical and laboratory investigation of our patient revealed a very efficient treatment strategy. Cases of Hashimoto's encephalopathy associated with the occurrence of a manic episode and hence with bipolar disorder are rare; this is the first reported case. However, clinicians should be alert to this possibility.
Müssig
Karsten
K
Division of Endocrinology, Metabolism and Pathobiochemistry, Department of Internal Medicine, University Hospital of Tübingen, Tübingen, Germany.
Bartels
Mathias
M
Gallwitz
Baptist
B
Leube
Dirk
D
Häring
Hans-Ulrich
HU
Kircher
Tilo
T
D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D013967:Thyroiditis, Autoimmune / Q000175:diagnosis* / Q000628:therapy
D011239:Prednisolone