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桥本脑病又称甲状腺毒性脑病、自身免疫性甲状腺炎相关的激素反应性脑病,是与桥本甲状腺炎相关的以神经系统功能紊乱为主的自身免疫性疾病,易被误诊。该文报道1例28岁女性患者,其以突发记忆力下降为首发症状,伴有桥本甲状腺炎及血液免疫学指标异常,头颅MRI显示双侧海马呈对称性损害,动脉自旋标记MRI呈局部异常高灌注,脑脊液细胞学检查可见免疫活性细胞。予大剂量甲泼尼龙冲击治疗后患者病情明显好转。2周后出院。出院后继续口服甲泼尼龙,随访2个月,患者有关生活细节的记忆力基本正常,但对数字的记忆及运用能力较发病前降低,工作能力下降。
Hashimoto’s encephalopathy, also known as thyroid toxic encephalopathy, autoimmune thyroiditis-related hormone-responsive encephalopathy is associated with Hashimoto’s thyroiditis with nervous system disorders mainly autoimmune diseases, easily misdiagnosed. This paper reports a 28-year-old female patient with sudden memory loss as the first symptom, accompanied by Hashimoto’s thyroiditis and abnormalities in hematological immunology, head MRI showed bilateral bilateral hippocampal symmetrical damage, MRI showed Local abnormal high perfusion, cytological examination of CSF showed immunocompetent cells. After the high-dose methylprednisolone shock treatment, the patient’s condition improved significantly. Discharged after 2 weeks. After discharge from the hospital, oral methylprednisolone continued to be administered. After 2 months of follow-up, the memory of patients with details of life was basically normal, but their ability to remember and use numbers was lower than that before the onset and the working ability declined.