title: Attempted infanticide and suicide inaugurating catatonia associated with Hashimoto's encephalopathy: a case report.
abstract: BACKGROUND
  Catatonia is a neuropsychiatric syndrome with motor and behavioural symptoms. Though usually occurring in patients with schizophrenia and mood disorders, this syndrome may also be associated with neurological diseases or general medical conditions. Few cases of catatonia associated with autoimmune disorders have been described.
  
  
  METHODS
  Here, we report the case of a 27-year-old woman diagnosed with Hashimoto's encephalitis (HE) who attempted suicide and infanticide by defenestration. As she presented risk factors for postpartum psychosis, she was treated principally with antipsychotics. Despite adequate treatment for psychosis, symptoms worsened and she developed catatonia. Complementary investigations showed elevated titres of anti-thyroglobulin and anti-thyroperoxidase antibodies (200 and 10 times, respectively, as compared to normal levels) and electroencephalography were suggestive of encephalopathy. In the presence of an otherwise unexplained neuropsychiatric condition, HE was suspected and oral prednisolone was introduced. Psychiatric symptoms improved dramatically within 72 h and the patient was still free of any symptom 3 years later.
  
  
  CONCLUSIONS
  Catatonia of organic aetiology should always be considered before a psychiatric aetiology especially in case of clinical worsening in spite of adequate psychotropic treatment. To our knowledge, this is the first description of catatonia associated with HE.
authors.affiliation: Department of Psychiatry, Fédération de Médecine Translationelle de Strasbourg (FMTS), University Hospital of Strasbourg, Strasbourg, France. laurence.lalanne@chru-strasbourg.fr.|INSERM 1114, Fédération de Médecine Translationelle de Strasbourg, University Hospital of Strasbourg, Strasbourg, France. laurence.lalanne@chru-strasbourg.fr.|INSERM1114-Department of Psychiatry, University of Strasbourg- 1 place de l'hôpital, 67000, Strasbourg, France. laurence.lalanne@chru-strasbourg.fr.
authors.forename: Laurence
authors.initials: L
authors.lastname: Lalanne
authors.affiliation: Department of Psychiatry, Fédération de Médecine Translationelle de Strasbourg (FMTS), University Hospital of Strasbourg, Strasbourg, France. marie-emmanuelle.meriot@chru-strasbourg.fr.
authors.forename: Marie-Emmanuelle
authors.initials: ME
authors.lastname: Meriot
authors.affiliation: Department of Neurology, Sleep and Electrophysiology Clinic, Fédération de Médecine Translationelle de Strasbourg (FMTS), University Hospital of Strasbourg, Strasbourg, France. elisabeth.ruppert@chru-strasbourg.fr.|Institute for Cellular and Integrative Neurosciences, CNRS - UPR 3212, Fédération de Médecine Translationelle de Strasbourg (FMTS), 67084, Strasbourg, France. elisabeth.ruppert@chru-strasbourg.fr.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Ruppert
authors.affiliation: Department of Psychiatry, Fédération de Médecine Translationelle de Strasbourg (FMTS), University Hospital of Strasbourg, Strasbourg, France. marie-agathe.zimermann@chru-strasbourg.fr.
authors.forename: Marie-Agathe
authors.initials: MA
authors.lastname: Zimmermann
authors.affiliation: Department of Psychiatry, Fédération de Médecine Translationelle de Strasbourg (FMTS), University Hospital of Strasbourg, Strasbourg, France. jean-marie.danion@chru-strasbourg.fr.|INSERM 1114, Fédération de Médecine Translationelle de Strasbourg, University Hospital of Strasbourg, Strasbourg, France. jean-marie.danion@chru-strasbourg.fr.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Danion
authors.affiliation: Department of Psychiatry, Fédération de Médecine Translationelle de Strasbourg (FMTS), University Hospital of Strasbourg, Strasbourg, France. pierre.vidailhet@chru-strasbourg.fr.|INSERM 1114, Fédération de Médecine Translationelle de Strasbourg, University Hospital of Strasbourg, Strasbourg, France. pierre.vidailhet@chru-strasbourg.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vidailhet
mesh_terms: D000328:Adult; D002389:Catatonia / Q000150:complications* / Q000523:psychology*; D004660:Encephalitis / Q000150:complications* / Q000523:psychology*; D005260:Female; D050031:Hashimoto Disease / Q000150:complications* / Q000523:psychology*; D006801:Humans; D007223:Infant; D007237:Infanticide / Q000523:psychology*; D013405:Suicide / Q000523:psychology*