title: Hashimoto's encephalopathy mimicking presenile dementia.
abstract: Hashimoto's encephalopathy (HE), which carries kaleidoscopic clinical presentations, is easily misdiagnosed in clinical practice. Early diagnosis and prompt initiation of steroid therapy are associated with good prognosis. We describe a 50-year-old female patient who had subclinical hypothyroidism and who presented herself with gradual cognitive impairment, accompanied with auditory hallucination and delusion. Increased anti-thyroid antibodies titers were found in her serum and cerebrospinal fluid. The HE diagnosis was confirmed using the laboratory test for anti-thyroid antibodies along with the patient's clinical presentation. We treated her with steroid pulse therapy, and the results were favorable. We highlight this case to call for early diagnosis and prompt intervention of HE in clinical practice.
authors.affiliation: Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
authors.forename: Kah Kheng
authors.initials: KK
authors.lastname: Goh
authors.affiliation: Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address: chiuyihang@gmail.com.
authors.forename: Yi-Hang
authors.initials: YH
authors.lastname: Chiu
authors.affiliation: Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Winston W
authors.initials: WW
authors.lastname: Shen
mesh_terms: D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003072:Cognition Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis; D003937:Diagnosis, Differential; D004660:Encephalitis; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000494:pharmacology*; D050031:Hashimoto Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology; D008875:Middle Aged; D011618:Psychotic Disorders / Q000188:drug therapy / Q000209:etiology; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone
keywords: Autoimmune disease; Dementia; Psychosis; Steroid; Thyroiditis