Open AccessAnti-Thyroid Peroxidase/Anti-Thyroglobulin Antibody-Related Neurologic Disorder Responsive to Steroids Presenting with Pure Acute Onset Chorea
Author(s) -
Ritwik Ghosh,
Subhankar Chatterjee,
Souvik Dubey,
Alak Pandit,
Biman Kanti Ray,
Julián BenitoLeón
Publication year - 2020
Publication title -
tremor and other hyperkinetic movements
Language(s) - English
Resource type - Journals
ISSN - 2160-8288
DOI - 10.5334/tohm.175
Subject(s) - medicine , chorea , thyroglobulin , thyroid peroxidase , prednisolone , encephalopathy , methylprednisolone , thyroid , gastroenterology , endocrinology , disease
Background: Pure acute onset chorea without encephalopathy has rarely been reported in anti-thyroid peroxidase (anti-TPO)/anti-thyroglobulin (anti-TG) antibody-related neurologic disorders responsive to steroids (ATANDS). Case report: We report a 16-year-old female who presented with acute chorea without encephalopathy. Anti-TPO antibodies were found to be strongly positive (>1200 IU/ml) along with anti-thyroglobulin and anti-thyroid stimulating hormone receptor antibodies. After pulse intravenous methylprednisolone therapy (1 g/day for five consecutive days), all the movements seized, and she was discharged with oral prednisolone 30 mg/day with gradual tapering over next three months. After one year of follow-up, she is stable, drug-free, and never had any other problems. Discussion: Anti-thyroid antibodies testing should be included in routine/conventional panel that is done for elucidating causes of chorea as ATANDS can be easily missed and is treatable with widely available, relatively low-cost drugs like steroids with a promising outcome.