Encephalitis ; diagnosis ; epidemiology ; etiology ; therapy ; Hashimoto Disease ; diagnosis ; epidemiology ; etiology ; therapy ; Humans

Child ; Humans ; Encephalitis/therapy* ; Hashimoto Disease/therapy* ; Autoimmune Diseases of the Nervous System/diagnosis*

Adolescent ; Child ; Child, Preschool ; Female ; Hashimoto Disease ; complications ; diagnosis ; drug therapy ; Humans ; Male

OBJECTIVES: To study the clinical features of children with autoimmune encephalitis (AE) secondary to epidemic encephalitis B (EEB). METHODS: A retrospective analysis was performed on the medical data of five children with EEB with "bipolar course" who were treated in Children's Hospital Affiliated to Zhengzhou University from January 2020 to June 2022. RESULTS: Among the five children, there were three boys and two girls, with a median age of onset of 7 years (range 3 years 9 months to 12 years) and a median time of 32 (range 25-37) days from the onset of EEB to the appearance of AE symptoms. The main symptoms in the AE stage included dyskinesia (5/5), low-grade fever (4/5), mental and behavioral disorders (4/5), convulsion (2/5), severe disturbance of consciousness (2/5), and limb weakness (1/5). Compared with the results of cranial MRI in the acute phase of EEB, the lesions were enlarged in 3 children and unchanged in 2 children showed on cranial MRI in the AE stage. In the AE stage, four children were positive for anti-N-methyl-D-aspartate receptor antibody (one was also positive for anti-γ-aminobutyric acid type B receptor antibody), and one was negative for all AE antibodies. All five children in the AE stage responded to immunotherapy and were followed up for 3 months, among whom one almost recovered and four still had neurological dysfunction. CONCLUSIONS EEB can induce AE, with anti-N-methyl-D-aspartate receptor encephalitis as the most common disease. The symptoms in the AE stage are similar to those of classical anti-N-methyl-D-aspartate receptor encephalitis. Immunotherapy is effective for children with AE secondary to EEB, and the prognosis might be related to neurological dysfunction in the acute phase of EEB.
Male ; Female ; Humans ; Child ; Infant, Newborn ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Retrospective Studies ; Hashimoto Disease/therapy* ; Encephalitis, Arbovirus

Autoimmune thyroid disease (AITD) includes hyperthyroid Graves disease, hypothyroid autoimmune thyroiditis, and subtle subclinical thyroid dysfunctions. AITD is caused by interactions between genetic and environmental predisposing factors and results in autoimmune deterioration. Data on polymorphisms in the AITD susceptibility genes, related environmental factors, and dysregulation of autoimmune processes have accumulated over time. Over the last decade, there has been progress in the clinical field of AITD with respect to the available diagnostic and therapeutic methods as well as clinical consensus. The updated clinical guidelines allow practitioners to identify the most reasonable and current approaches for proper management. In this review, we focus on recent advances in understanding the genetic and environmental pathogenic mechanisms underlying AITD and introduce the updated set of clinical guidelines for AITD management. We also discuss other aspects of the disease such as management of subclinical thyroid dysfunction, use of levothyroxine plus levotriiodothyronine in the treatment of autoimmune hypothyroidism, risk assessment of long-standing antithyroid drug therapy in recurrent Graves' hyperthyroidism, and future research needs.
Causality ; Consensus ; Drug Therapy ; Genes, rel ; Graves Disease ; Hashimoto Disease ; Hyperthyroidism ; Hypothyroidism ; Risk Assessment ; Thyroid Diseases* ; Thyroid Gland* ; Thyroiditis, Autoimmune ; Thyroxine

Idiopathic retroperitoneal fibrosis (IRPF) is a rare disease characterized by a retroperitoneal inflammatory proliferative fibrosing process. Hashimoto's thyroiditis is the most common inflammatory condition of the thyroid gland; and is a frequently-occurring autoimmune disorder manifesting predominantly in middle-aged women. We report a rare association of IRPF with Hashimoto's thyroiditis in a 67-year-old man demonstrating good response to steroid therapy.
Aged ; Anti-Inflammatory Agents/therapeutic use ; Hashimoto Disease/*complications/drug therapy ; Humans ; Male ; Pregnenediones/therapeutic use ; Retroperitoneal Fibrosis/*complications/drug therapy/pathology

OBJECTIVETo explore the effects on thyroid function in patients of Hashimoto's thyroiditis treated with aconite cake-separated moxibustion and option the better therapeutic program.

METHODSEighty-five cases were randomly divided into a moxibustion group (42 cases) and a western medication group (43 cases). The moxibustion group was treated by aconite cake-separated moxibustion therapy with acupoints of two groups [(1) Danzhong (CV 17), Zhongwan (CV 12), Guanyuan (CV 4); (2) Dazhui (GV 14), Shenshu (BL 23), Mingmen (GV 4)] alternatively and oral administration of 25 microg Euthyrox everyday. The western medication group was oral administration of 25 microg Euthyrox everyday. Indices of thyroid function before and after treatment and clinical effect were compared between two groups.

RESULTSThe clinical total effective rate and effective rate of thyroid function were 25.0% (10/40), 87.5% (35/40) in moxibustion group respectively, 7.53% (3/40) and 57.5% (23/40) in western medication group, with significant differences between two groups (both P < 0.05). Content of serum free thyroxine index (FT4) increased significantly in the moxibustion group after treatment (P < 0.01); content of serum supersensitive thyrotropin (S-TSH) in the moxibustion group was lower than that of western medication group, and contents of serum FT4 and free triiodothyronine (FT3) were higher than those of western medication group, but with no significant differences (all P > 0.05).

CONCLUSIONAconite cake-separated moxibustion at Guanyuan (CV 4) and Mingmen (GV 4) combined with oral administration of Euthyrox can improve clinical symptoms and thyroid function in patients of Hashimoto's thyroiditis, which is better than simple oral administration of Euthyrox.

Aconitum ; chemistry ; Acupuncture Points ; Adult ; Aged ; Female ; Hashimoto Disease ; blood ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Thyroid Gland ; physiopathology ; secretion ; Thyroid Hormones ; blood ; Thyrotropin ; blood ; Young Adult

We present a case of a 53-year-old woman with a rapidly growing neck mass. She had one-year history of hypothyroidism associatied with Hashimoto thyroiditis. She had noticed progressive dyspnea with rapid enlargement of the thyroid gland over a month. An incisional biopsy of the thyroid gland for combined pathology and immunohistochemistry revealed diffuse large B cell non-Hodgkin's lymphoma. A combined chemotherapy including cyclophosphamide, doxorubicin, vincristine, prednisone plus rituximab (R-CHOP) was initiated, which dramatically shrunk the tumor and completely resolved the compression symptoms within a few days. Here we report on a case of thyroid lymphoma with a review of the relevant literature.
Antibodies, Monoclonal, Murine-Derived ; Biopsy ; Cyclophosphamide ; Doxorubicin ; Drug Therapy, Combination ; Dyspnea ; Female ; Hashimoto Disease ; Humans ; Hypothyroidism ; Immunohistochemistry ; Lymphoma ; Lymphoma, Non-Hodgkin ; Neck ; Prednisone ; Thyroid Gland ; Vincristine ; Rituximab

OBJECTIVETo explore the principles of diagnosis and treatment of chronic lymphocytic thyroiditis (CLT) coexistent with thyroid malignancy.

METHODSThe clinical data of 52 patients with CLT, including clinicopathologic features, treatment, and prognosis were retrospectively analyzed. Among these 52 patients, 40 patients had coexisting thyroid carcinoma (TC group) and 12 had coexisting thyroid lymphoma (TL group).

RESULTSThese two thyroid malignancies accounted for 13.87% of all the CLT inpatients during this period, in which 10.67% were CLT with carcinoma and 3.20% were CLT with lymphoma. Significant differences existed between TC group and TL group in sex (P = 0.008) , age (P = 0.000), and B-mode ultrasound findings (P = 0.000). Most patients in TC group received total lobectomy of one lobe and subtotal lobectomy of the other side, of which some received elective lymphadenectomy. The operations varied among patients in TL group, and most of them received chemotherapy after surgery. The median follow-up was (35.51 +/- 39.84) months for 37 patients in TC group, and 36 patients survived with a median period of (34.50 +/- 39.91) months; the median follow-up was (39.50 +/- 29.00) months for 12 patients in TL group, and 10 patients survived with a median period of (44.70 +/- 28.78) months.

CONCLUSIONSCLT with thyroid malignancies are not uncommon in clinical practice. While thyroid carcinoma accounts for majority of these malignancies, its clinicopathologic features, treatment, and prognosis differs with thyroid lymphoma. Surgery may be appropriate for CLT patients with rapid thyroid enlargement or nodule, and for patients with solitary solid nodule or nodules with calcification revealed by B ultrasound.

Adult ; Aged ; Carcinoma ; complications ; diagnosis ; therapy ; Female ; Follow-Up Studies ; Hashimoto Disease ; complications ; diagnosis ; therapy ; Humans ; Lymphoma ; complications ; diagnosis ; therapy ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms ; complications ; diagnosis ; therapy

A 12-year-old girl presented with a history of cervical mass, and one week of throat discomfort and dyspnea. Five years ago, the patient was diagnosed as Hashimoto's thyroiditis and hyperthyroidism; she received antithyroid drug treatment, but the result was not satisfactory. B-ultrasonic showed that the size of thyroid gland was 8.1 cm×3.2 cm in the left and 8.2 cm×4.8 cm in the right. After iodine 131 combined with radiofrequency ablation (RFA) treatment, throat discomfort and recumbent breathing difficulties disappeared, and B-ultrasonic showed that the size of thyroid reduced to 2.3 cm×1.7 cm (left) and 2.8 cm×2.0 cm (right). No recurrence was observed during the two and a half years of follow-up.
Ablation Techniques ; methods ; Child ; Dyspnea ; etiology ; therapy ; Female ; Goiter ; complications ; diagnostic imaging ; pathology ; therapy ; Hashimoto Disease ; therapy ; Humans ; Hyperthyroidism ; therapy ; Iodine Radioisotopes ; therapeutic use ; Radio Waves ; therapeutic use ; Ultrasonography