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Hashimoto's Encephalopathy with Unusual MRI Findings Mimicking Meningoencephalitis: A Case Report and Literature Review

수막뇌염을 모방한 드문 뇌 자기공명영상 소견을 보인 하시모토 뇌병증: 증례 보고 및 문헌고찰

  • Hie Bum Suh (Departement of Radiology, Pusan National University Hospital) ;
  • Hyunseuk Kim (Department of Psychiatry, National Center for Mental Health) ;
  • Hak Jin Kim (Departement of Radiology, Pusan National University Hospital)
  • 서희붐 (부산대학교병원 영상의학과) ;
  • 김현석 (국립정신건강센터 정신건강의학과) ;
  • 김학진 (부산대학교병원 영상의학과)
  • Received : 2019.04.23
  • Accepted : 2019.07.01
  • Published : 2020.03.01

Abstract

Hashimoto's encephalopathy (HE) is a rare autoimmune disease characterized by a high serum concentration of antithyroid antibodies without evidence of cerebral disease. Magnetic resonance imaging (MRI) findings in HE patients are nonspecific, although diffuse or focal white matter changes have been reported in several cases. We present a rare case involving a 79-year-old woman with elevated antithyroid antibody levels and abnormal imaging findings similar to meningoencephalitis. Serial MRI initially showed multiple T2 hyperintense lesions with diffuse leptomeningeal enhancement that disappeared after steroid therapy.

하시모토 뇌병증은 다른 대뇌 질환의 증거가 없이 항갑상선 항체의 높은 혈청 농도를 특징으로 하는 드문 자가 면역 질환이다. 하시모토 뇌병증의 자기공명영상 소견은 비특이적이고, 현재까지 미만성 또는 국소 백질 변화가 보고 된 바 있다. 저자는 증가된 항갑상선 항체와 동반하여 수막뇌염과 유사한 영상 소견을 보인 79세 여성의 하시모토 뇌병증을 경험하여 이에 대해 보고하고자 한다. 환자의 일련의 자기공명영상에서 치료 전 관찰되던 여러 T2-고강도 병변과 미만성의 뇌수막 조영증강은 스테로이드 요법 후 소실되었다.

Keywords

References

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