Debut with psychotic symptoms of Hashimoto encephalopathy: A case report

Angela Daniela Ortiz Arce1, Henry Sánchez-Rueda1

  • 1Universidad Nacional de San Agustín, Unidad de Segunda Especialidad Médica, Facultad de Medicina Humana, Arequipa, Perú.

Medwave
|October 19, 2022
PubMed

Hashimoto's encephalopathy is a rare disease, first reported in 1966, with a prevalence of 2.1 in 1000 inhabitants. We present the case of a 42- year- old woman, with no relevant medical history, who suddenly started having symptoms of altered consciousness, visual hallucinations and de-lusions. Laboratory tests showed anti- thyroperoxidase antibodies greater than 600 U/ml, thy-roxin 0.93 U/ml, and thyroid stimulating hormone 1.60 U/ml. Magnetic resonance imaging showed bilateral subcortical focal lesions with a nonspecific demyelinating appearance. The electroencephalogram was nonspecific. The diagnosis of Hashimoto encephalopathy was made, and symptoms remitted after treatment with steroids. This article highlights the importance of conducting a comprehensive evaluation of patients with atypical psychiatric symptoms and a thorough differential diagnosis.

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