Steroid Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) or Hashimoto’s Encephalopathy: A Masquerader of Acute Psychosis

Abstract

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) or Hashimoto’s encephalopathy is a relatively rare condition; it is a poorly understood entity and is often misdiagnosed and mistreated. It is seen in a very small percentage of patients, who have an autoimmune thyroid disease and a high level of anti-thyroid antibodies. This condition causes various neurological and psychiatric disorders. Although the exact association between SREAT and thyroid disorder is not yet established, it is important to diagnose SREAT. This condition is treatable and often reversible. Here, we report a case of a 24-year-old female, who was being treated for Vitamin B12 deficiency, anaemia, and hypothyroidism. She suddenly developed encephalopathy. After ruling out other causes, we detected elevated levels of thyroid peroxidase (TPO). Therefore, a diagnosis of Hashimoto’s encephalopathy was made, and the patient responded dramatically to steroids.

Conflict of Interest: None declared
Source of Support: None declared