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Pediatric Hashimoto's encephalopathy with peripheral nervous system involvement
Vincenzo Salpietro1, Kshitij Mankad, Agata Polizzi
1Department of Paediatrics, University of Messina, Messina, Italy.
Summary
Hashimoto encephalopathy can affect the peripheral nervous system in children. Steroid treatment led to significant neurological and psychiatric recovery in a young patient.
Area of Science:
- Neurology
- Endocrinology
- Immunology
Background:
- Hashimoto encephalopathy (HE) is a rare neurological disorder characterized by encephalopathy and elevated anti-thyroid antibodies.
- It typically responds to corticosteroid therapy, but peripheral nervous system (PNS) involvement is seldom reported, especially in pediatric cases.
Observation:
- A 13-year-old girl presented with symptoms of HE, including fever, headache, cognitive impairment, hallucinations, and ileus.
- Neurological examination revealed reduced deep tendon reflexes and distal sensory deficits, indicating PNS involvement.
- Laboratory tests confirmed elevated anti-thyroglobulin and anti-thyroperoxidase antibodies.
Findings:
- The patient received intravenous methylprednisolone, resulting in progressive neurological and psychiatric remission.
- Follow-up MRI demonstrated complete resolution of brain lesions.
- This case is the first to document PNS involvement in a child diagnosed with HE.
Implications:
- This case highlights the potential for peripheral nervous system manifestations in pediatric Hashimoto encephalopathy.
- Early diagnosis and prompt steroid treatment are crucial for favorable outcomes.
- Further research is warranted to understand the pathophysiology and spectrum of HE, particularly its impact on the PNS in children.
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