Pediatric H ashimoto's encephalopathy with peripheral nervous system involvement

• Published in: Pediatrics international 2014-06, Vol.56 (3), p.413-416
• Main Authors: Salpietro, Vincenzo, Mankad, Kshitij, Polizzi, Agata, Sugawara, Yuji, Granata, Francesca, David, Emanuele, Ferraù, Valeria, Gallizzi, Romina, Tortorella, Gaetano, Ruggieri, Martino
• Format: Article
• Language: English
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.12262

Hashimoto encephalopathy is a syndrome of encephalopathy associated with elevated concentration of circulating serum anti‐thyroid antibodies usually responsive to steroid therapy. We report a 13‐year‐old girl with Hashimoto encephalopathy and peripheral nervous system involvement. The child had experienced high‐grade pyrexia, global headache and sleeplessness. After admission she had an ileus with a distended urinary bladder, hallucinations and cognitive impairment. She had reduced deep tendon reflexes and distal sensory deficiency. Anti‐thyroglobulin antibodies were raised at 2121  IU /mL (normal, 0–40) and the anti‐thyroperoxidase was high at 886  IU /mL (normal, 0–50). Progressive neurological and psychiatric remission was noted after i.v. methylprednisolone. Follow‐up magnetic resonance imaging showed complete resolution of the foci of signal abnormality previously yielded. This case report is the first, to the best of our knowledge, to describe peripheral nervous system involvement in a child with a diagnosis of Hashimoto's encephalopathy.