橋本氏腦病 經典幻燈

1、Lord Brain在Lancet上報道了一例患者：男，49歲，主要表現為波動性意識障礙、幻覺 、認知功能損害和卒中樣發(fā)作。既往橋本甲狀腺炎輔助檢查：甲功（T3T4）低于正常，血抗甲狀腺球蛋白抗體(anti-TG)和抗甲狀腺微粒體抗體(anti-M)明顯增高；腦脊液蛋白增高。經激素和甲狀腺素治療好轉。Brain L. Hashimotos disease and en-cephalopathy. Lancet 1966 Sep 3; 2 (7462): 512-4encephalopathy associated with Hashimotos thyroiditissteroid-respo

2、nsive encephalopathy associated with autoim-mune thyroiditis，SREAT)患病率：2.1/100 000發(fā)病年齡：9-86歲（平均45-55歲）男女比例：1:5沒有家族性橋本腦病的報道可以合并其它自身免疫?。ㄈ鏢LE、I型糖尿病等）anti-TG)anti-Manti-TPOFigure 2. Axial T2-weighted MRI brain scan through the temporal lobes shows bilateral areas of increased signal intensity involving

3、the mesial temporal lobes and hippocampi (arrows).Figure 1. Sagittal T1-weighted MRI brain (without gadolinium) demonstrates a low signal intensity lesion, with localized swelling of the right mesial temporal lobe (arrow). Fig. 2 MRI one day after admission: axial FLAIR images show widespread hyperi

4、ntense signals over the left temporal and both parieto-occipital lobes in the subcortical white matterDuffey P. Hashimotos encephalopathy: postmortem findings after fatal status epilepticus. Neurology. 2003 Oct 28;61(8):1124-6. The neuropathological features include discrete areas of emyelination (G; areas of pallor on Hematoxylin and Eosin arrowheads, H; Luxol Fast Blue staining) with relative reservation of axons (I; Bielschowsky staining). The lack of erivascular cuffs is evident in the Hematoxylin and Eosin staining (G).臨床主要表現為認知功能障礙、