title: Unusual case of Hashimoto's encephalopathy and pseudo-obstruction in a patient with undiagnosed hypothyroidism: a case report.
abstract: BACKGROUND
  Hashimoto's encephalopathy is a relatively rare condition associated with an elevated concentration of circulating serum anti-thyroid antibodies, and is usually responsive to steroid therapy. However, hypothyroidism is a rare cause of pseudo-obstruction so here we present a case report of Hashimoto's encephalopathy with gut pseudo-obstruction in an undiagnosed hypothyroid patient.
  
  
  METHODS
  A diagnosis of unknown aetiology of encephalopathy with gut dysmotility in an undiagnosed profound hypothyroidism case associated with cognitive decline and behavioural disorder was made in a 60-year-old Indian man. The associated clinical and laboratory features led to the final diagnosis of overt hypothyroidism with Hashimoto's encephalopathy with gut pseudo-obstruction.
  
  
  CONCLUSIONS
  Hashimoto's encephalopathy is a rare disorder presenting with acute or sub acute encephalopathy of unknown aetiology so there are considerable chances of misdiagnosing it. The unusualness of this case is that since hypothyroidism is a rare cause of intestinal pseudo-obstruction, and presented concomitant with Hashimoto's encephalopathy, that itself is a rare entity. Intestinal pseudo-obstruction is a potentially serious complication that must be recognized and treated promptly with adequate thyroid hormone therapy.
authors.affiliation: Department of General Medicine Rama Medical College Hospital & Research Centre, Ghaziabad 245304, UP, India. sherairfan@gmail.com.
authors.forename: Irfan A
authors.initials: IA
authors.lastname: Shera
authors.forename: Anurag
authors.initials: A
authors.lastname: Vyas
authors.forename: Mohd Shafi
authors.initials: MS
authors.lastname: Bhat
authors.forename: Qayser
authors.initials: Q
authors.lastname: Yousuf
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D003937:Diagnosis, Differential; D004660:Encephalitis; D004917:Erythromycin / Q000627:therapeutic use; D050031:Hashimoto Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007037:Hypothyroidism / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D007418:Intestinal Pseudo-Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D013396:Suction / Q000379:methods; D013974:Thyroxine / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D004917:Erythromycin; D013974:Thyroxine; D011241:Prednisone; D006854:Hydrocortisone