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Objective: As an ill-defined syndrome consisting of heterogeneous neurological symptoms and high serum antithyroid antibody titers, Hashimoto's encephalopathy typically responds to steroids. More serial clinical studies are required to characterize the clinical, laboratory and imaging features and outcomes., Methods: We analyzed retrospectively the clinical, laboratory, and imaging features and outcomes of 15 consecutive patients with Hashimoto's encephalopathy diagnosed at our hospital from 2005 to 2011., Results: Cognitive impairment (11/15) and psychiatric symptoms (5/15) were the most frequent manifestations. Seizure (4/15) and myoclonus (1/15) were less common than previously described. Three (3/15) patients showed abnormal signals in hippocampus or temporal lobe related to memory disorders. Among 10 patients on steroid therapy, there were recovery (n = 5), improvement with residual deficits (n = 2) and relapse or no effect (n = 3). Among 5 patients on non-steroid, there were stable remission with antiepileptic drugs or general neurotrophic therapy (n = 3) and continuous deterioration (n = 2)., Conclusion: Most patients respond well to steroids while someone improves without steroid therapy. In light of its reversible course, we recommend that Hashimoto's encephalopathy should always be considered in the differential diagnosis while evaluating disorders of central nervous system, even disorders those without manifestations of encephalopathy.

Objective: To investigate the relation of thyroid function with hashimoto thyroiditis (HT, an autoimmune disease of unknown etiology also known as chronic lymphocytic thyroiditis) in patients with chronic hepatitis C (CHC) receiving treatment with pegylated-interferon-alpha (Peg-IFNa) based on the observation that HT is common among individuals undergoing IFN-based therapy., Methods: One-hundred-and-seven patients with chronic hepatitis C were enrolled for study between January 2008 and December 2010. Thyroid function was assessed by electrochemiluminescence assays to detect serum levels of anti-thyroid peroxidase (A-TPO) antibodies, thyroid stimulating hormone (TSH), and free thyroxine (FT4) prior to initiation of the IFN-based therapy. The treatment strategies (drugs, doses, schedules) were designed according to HT status (CHC with HT, or CHC without HT). Patients were monitored during the 24 weeks of treatment (including measuring serum alanine aminotransferase (ALT), TSH, and FT4 every two to four weeks, and HCV RNA every four weeks) so that the IFNa dose could be adjusted and thyroid medications (levothyroxine sodium or methimazole) added as necessary. The response rate at end of treatment (week 24) was assessed., Results: Twenty-one of the CHC patients were diagnosed with HT, and the incidence of thyroid dysfunction among the CHC patients with HT was 71.4% (15/21); among the CHC patients with no HT, the incidence of thyroid dysfunction was significantly lower (30.2% (26/86), X2 = 12.1995, P less than 0.01). In the CHC patients with HT, 90.5% (19/21) had serum levels of A-TPO antibodies that were more than or equal to 2-times higher than the normal value at the end of treatment. Of the 15 CHC patients with HT and thyroid dysfunction, 73.3% (11/15) continued to show thyroid dysfunction at the end of treatment. Hypothyroidism was the most common form of thyroid dysfunction observed (4/11), and all of those patients responded to levothyroxine sodium treatment. The virological response rates of the two groups (CHC with HT and CHC without HT) were not significantly different at any time point examined (treatment week 4, 12, and 24, P more than 0.05)., Conclusion: The incidence of thyroid dysfunction is significantly higher among CHC patients with HT than among CHC patients without HT. If suspected, these patients should be carefully monitored because the clinical symptoms of thyroid dysfunction are not obvious and the drug therapy should be carefully adjusted to minimize the thyroid dysfunction while maximizing the antiviral effect.

Objective: To evaluate the clinical outcome of Ruanjian Xiaoying Decoction (RJXYD) on chronic lymphocytic thyroiditis., Methods: Eighty patients with chronic lymphocytic thyroiditis were randomly divided into RJXYD-treated group (n=40) and control group (n=40). The patients in the RJXYD-treated group received treatment of RJXYD combined with levothyroxine while the others in the control group received treatment of levothyroxine and prednisone both for 16 weeks. The serum levels of thyroid hormones and the titres of serum antithyroglobulin antibody (anti-TG Ab) and antithyroid microsomal antibody (anti-TM Ab) were all examined before and after treatment. The total response rates of the two groups were evaluated after treatment of 16 weeks., Results: The total response rate of the RJXYD-treated group was 92.5%, while that of the control group was 60.0% (P<0.01). The serum levels of free triiodothyronine (FT(3)) and free thyroxine (FT(4)) were obviously increased after treatment as compared with those before treatment in the two groups. The titres of serum anti-TG Ab and anti-TM Ab and the serum level of thyroid-stimulating hormone (TSH) were all obviously decreased after treatment as compared with those before treatment in the two groups., Conclusion: The RJXYD can shrink and soften the enlarged thyroid gland and thyroid nodules, improve the immune function of human body, alleviate the response to thyroid self-antigens and promote the recovery of thyroid function.