Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT): A Case Report

Document Type : Original Article

Author

Department of Internal Medicine, College of Medicine, King Faisal University, Al Ahsa, Kingdom of Saudi Arabia

Abstract

Background: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto’s encephalopathy, is a disorder characterized by an encephalopathy associated with anti-thyroid antibodies in the absence of alternative causes. It has a wide range of clinical, laboratory and radiological features.
Objective: Cases of steroid-responsive encephalopathy associated with autoimmune thyroiditis are difficult to diagnose and requires a high index of suspicion, as this will determine the early timing of management and disease outcome.
Patient and Methods: Here we present a case report of twenty-year-old woman presenting with neurological and psychological symptoms. She was found to have high anti-thyroid peroxidase antibodies (Anti-TPO) with normal thyroid function and negative screening for other etiologies of encephalopathy. Based on her presentation, she was diagnosed with steroid-responsive encephalopathy associated with autoimmune thyroiditis.
Results: Patient was started on high dose steroids upon which she responded partially. Then she required the addition of immunotherapy in the form of Rituximab to improve her symptoms.
Conclusion: After exclusion of other causes of encephalopathy, the presence of thyroid antibodies prompts the susp < /span>icion of SREAT and therefore the early initiation of steroids to improve patients’ outcome.

Keywords

The Egyptian Journal of Hospital Medicine
Volume 81, Issue 1
October 2020
Pages 1231-1233

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