Case Report: Paraneoplastic Hashimoto's Encephalopathy Associated With Lymphomatosis Cerebri With Periodic Synchronous Discharges Resembling Creutzfeldt–Jakob Disease
Autor: | Ryota Amano, Katsumi Taki, Setsuro Tsukada, Kenjiro Ono, Shota Kosuge, Makoto Yoneda, Satoshi Yano |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Pathology
medicine.medical_specialty anti-NH2-terminal of α-enolase antibody medicine.diagnostic_test business.industry periodic synchronous discharge Brain biopsy Encephalopathy Creutzfeldt–Jakob disease Hashimoto's encephalopathy Case Report Disease medicine.disease lymphomatosis cerebri Hyperintensity Midbrain Personality changes Neurology medicine Neurology (clinical) Neurology. Diseases of the nervous system Complication business RC346-429 |
Zdroj: | Frontiers in Neurology, Vol 12 (2021) Frontiers in Neurology |
ISSN: | 1664-2295 |
Popis: | Hashimoto's encephalopathy (HE) is an autoimmune encephalopathy that presents with various clinical symptoms, including cognitive deterioration, convulsive seizures, and personality changes. HE is associated with thyroid autoimmunity; however, few cases have been reported to develop as paraneoplastic syndrome. Herein, we report the case of a 73-year-old woman with onset of rapidly progressive dementia. Brain magnetic resonance imaging showed diffuse T2 hyperintensity areas involving the bilateral cerebral white matter, right midbrain tegmental area, left cerebral peduncle, and right middle cerebellar peduncle without clear diffusion hyperintensities and gadolinium enhancement. Her neurological symptoms worsened rapidly, and she presented with the apallic syndrome. Electroencephalogram showed periodic synchronous discharge, suggestive of Creutzfeldt–Jakob disease. However, a brain biopsy revealed infiltration of atypical lymphoid cells expressing CD20, and the anti-NH2 terminal of the α-enolase antibody was detected, diagnosing the complication with lymphomatosis cerebri and HE. High-dose intravenous methylprednisolone therapy and oral prednisolone with whole cranial irradiation enabled her to have simple conversations and consume food orally; however, severe cognitive impairment persisted. Although HE is a rare complication of malignant lymphoma, clinicians should be aware that it could be strongly suspected if the clinical symptoms worsen in the absence of imaging changes. |
Databáze: | OpenAIRE |
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