Hashimoto thyroiditis,distal renal tubular acidosis,pernicious anaemia and encephalopathy: A rare combination of auto-immune disorders in a 12-year-old girl |
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Authors: | N. Suzuki R. Mitamura H. Ohmi Y. Itoh K. Yano A. Okuno M. Tateno T. Itoh |
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Affiliation: | (1) Department of Paediatrics, Asahikawa Medical College, Nishikagura 4-5-3-11, 078 Asahikawa, Japan;(2) Department of Paediatrics, Hokkaido Ryouikuen, Shunkodai 4-10, 071 Asahikawa, Japan;(3) Department of Pathology, Sapporo City General Hospital, Chuo-ku Kita 1, Nishi 9, 060 Sapporo, Japan |
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Abstract: | A case of a 12-year-old girl with a multiple auto-immune disorder is reported. She showed Hashimoto thyroiditis which subsequently developed to hashitoxicosis and distal renal tubular acidosis at 5 years of age, pernicious anaemia at the age of 9 and severe encephalopathy at the age of 12. Laboratory studies revealed very high titres of anti-microsomal and anti-thyroglobulin antibodies and positive gastric parietal cell antibody. As to the encephalopathy, positive oligoclonal IgG bands and high values of IgG index and IgG synthesis ratio in CSF were observed with aggravation of her neurological symptoms. High-dose steroid therapy was effective toward the encephalopathy. Paediatricians should pay careful attention to patients with Hashimoto thyroiditis for association with other auto-immune disorders. |
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Keywords: | Hashimoto thyroiditis Renal tubular acidosis Pernicious anaemia Encephalopathy Auto-immune disease |
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