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[Cotard-syndrome associated with Hashimoto encephalopathy: a case report]
1Nyírő Gyula Országos Pszichiátriai és Addiktológiai Intézet, Budapest, Hungary. lazaryjudit@gmail.com.
Summary
Hashimoto-encephalopathy, a rare autoimmune brain disorder, can manifest as Cotard syndrome, a severe psychiatric condition. Early diagnosis and steroid treatment are crucial for managing this challenging presentation.
Area of Science:
- Neuroscience
- Psychiatry
- Immunology
Background:
- Encephalopathy-related psychiatric syndromes pose significant clinical management challenges.
- Cotard syndrome, a rare psychiatric condition, has been linked to various organic causes but not previously to Hashimoto-encephalopathy.
Observation:
- A 44-year-old woman presented with Cotard II syndrome, characterized by psychotic depression with nihilistic delusions.
- She exhibited cognitive, motor, and vegetative symptoms, prompting a thorough exclusion of other organic brain disorders.
- Elevated anti-TPO levels, non-specific MRI abnormalities, and a history of thyroid disease were noted.
Findings:
- The patient was diagnosed with Hashimoto-encephalopathy (HE), confirmed by a positive response to steroid therapy.
- This case represents the first documented association between Hashimoto-encephalopathy and Cotard syndrome.
- Hashimoto-encephalopathy, also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), is often linked to psychiatric syndromes.
Implications:
- This case underscores the significant role of autoimmune diseases in the pathophysiology of psychiatric disorders.
- It highlights the critical importance of interdisciplinary diagnostic approaches in psychiatry.
- Early recognition and treatment of autoimmune encephalopathies are vital for managing complex psychiatric presentations.
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