Journal article
Cerebrospinal Immunoglobulin Level Changes and Clinical Response to Treatment of Hashimoto’s Encephalopathy
American journal of Alzheimer's disease and other dementias, v 24(5), pp 373-376
Oct 2009
PMID: 19561326
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
We describe a 64-year-old male who presented with a 2-year history of behavioral and cognitive decline. Brain imaging showed nonenhancing hemispheric white matter lesions. Blood work revealed elevated thyroglobulin and thyroperoxidase antibody levels. Cerebrospinal fluid (CSF) analysis was largely negative, except for an elevated protein and immunoglobulin G (IgG) level. Because of the absence of stroke, central nervous system (CNS) tumor, or infection, this patient fits into criteria of Hashimoto’s encephalopathy. His Mini-Mental State Examination score improved from 10 to 29 after initial immunotherapy. The patient remained stable over 6 months with monthly outpatient total plasma exchange, but symptoms recurred within 3 months when the outpatient therapy was discontinued. A follow-up CSF IgG level was found to be increased and the treatment was repeated with partial clinical improvement and decline in CSF IgG level. He then underwent high dose steroid treatment after which patients’ clinical condition stabilized and CSF analysis showed even further IgG decline.
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Details
- Title
- Cerebrospinal Immunoglobulin Level Changes and Clinical Response to Treatment of Hashimoto’s Encephalopathy
- Creators
- Gediminas Gliebus - Drexel UniversityCarol F. Lippa - Drexel University
- Publication Details
- American journal of Alzheimer's disease and other dementias, v 24(5), pp 373-376
- Publisher
- SAGE Publications
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000270454100002
- Scopus ID
- 2-s2.0-70349687251
- Other Identifier
- 991019169555204721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Geriatrics & Gerontology