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Subacute cognitive deterioration with high serum anti‐thyroid peroxidase antibodies: two cases and a plea for pragmatism
Author(s) -
Segers Kurt,
Braconnier Philippe,
Corazza Francis,
Divano Luisa,
Mabrouk Asmaa,
Robberecht Jean,
Surquin Murielle
Publication year - 2013
Publication title -
psychogeriatrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.647
H-Index - 32
eISSN - 1479-8301
pISSN - 1346-3500
DOI - 10.1111/psyg.12018
Subject(s) - medicine , thyroid peroxidase , etiology , plea , thyroid , differential diagnosis , antibody , encephalopathy , cognition , anti thyroid autoantibodies , autoantibody , immunology , pediatrics , pathology , psychiatry , political science , law
Abstract Autoimmune encephalopathy is a rare but potentially reversible cause of cognitive deterioration and neuropsychiatric disturbances. We describe two older female patients with subacute cognitive decline and marked neuropsychiatric disturbances in the presence of high serum anti‐thyroid peroxidase antibodies and with normal dosage of free thyroxine 4. One patient recovered almost completely after oral corticotherapy. Differential diagnosis and the role of biomarkers, in particular, are discussed. We support a pragmatic approach involving a short empirical therapeutic trial with intravenous or oral corticoids; this should be considered in all patients with subacute encephalopathy and with laboratory arguments for an underlying autoimmune aetiology.