title: The use of plasma exchange in Hashimoto's encephalopathy: A case report and review of the literature.
abstract: Hashimoto's Encephalopathy (HE) is a very rare condition characterized by psychosis, seizures, cognitive fluctuations, and myoclonus. In a few published cases, plasma exchange has been used due to the theoretical removal of antithyroid peroxidase antibodies (anti-TPO), one of the postulated causes of the condition. We report a case of HE treated by plasma exchange where no clinical or neurophysiologic improvement was observed despite documented reduction of the anti-TPO antibody to levels below the limits of laboratory detection. We discuss these findings in the context of the known literature for this disease process.
authors.affiliation: Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Melissa K
authors.initials: MK
authors.lastname: Cook
authors.affiliation: Department of Neurology, Virginia Commonwealth University, Richmond, Virginia.
authors.forename: Mark
authors.initials: M
authors.lastname: Malkin
authors.affiliation: Medical Sciences Institute, BloodCenter of Wisconsin, Milwaukee, Wisconsin.|Department of Pathology, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Karafin
mesh_terms: D001323:Autoantibodies / Q000097:blood; D001781:Blood Component Removal / Q000379:methods*; D003072:Cognition Disorders / Q000150:complications; D004660:Encephalitis / Q000150:complications / Q000628:therapy*; D005260:Female; D050031:Hashimoto Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007453:Iodide Peroxidase / Q000276:immunology; D008875:Middle Aged; D010259:Paranoid Disorders / Q000150:complications; D010951:Plasma Exchange / Q000379:methods*; D010956:Plasmapheresis / Q000379:methods; D013226:Status Epilepticus / Q000150:complications; D013256:Steroids / Q000627:therapeutic use
chemical_list: D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous; D013256:Steroids; D007453:Iodide Peroxidase
keywords: Hashimoto's encephalopathy; pheresis indications; plasma exchange