Atypical euthyroid presentation of Steroid Responsive Encephalopathy with Associated Thyroiditis

A Case Report

Authors

  • Vineeth Bhogadi McMaster University, Michael G DeGroote School of Medicine
  • Arlene Kelly-Wiggins Geriatric and Memory Disability Clinic, Cape Breton Regional Hospital, Nova Scotia Health Authority

Keywords:

Hashimotos, steroid-responsive, encephalopathy, dementia

Abstract

Introduction

Steroid-responsive encephalopathy with associated thyroiditis (SREAT) is an autoimmune disease associated with antithyroid antibodies. Its clinical features are variable, ranging from sudden focal neurologic deficits to progressive sub-acute cognitive decline and thus, can mimic a host of other neurological and psychiatric conditions.

Case Presentation

We present the case of a previously healthy 62-year-old female with rapid onset neurocognitive and functional decline. EEG and MRI findings were consistent with an encephalopathy of unknown origin. Serologic findings revealed elevated antithyroid antibodies but were otherwise insignificant.

Conclusion

Steroid-responsive encephalopathy with associated thyroiditis is typically a diagnosis of exclusion but should always be considered in cases of encephalopathy of unknown origin. The disorder is often underdiagnosed due to its variable presentation and poorly understood pathophysiology, but prognosis can be significantly improved with greater physician awareness and prompt management with corticosteroids.

Author Biography

Arlene Kelly-Wiggins, Geriatric and Memory Disability Clinic, Cape Breton Regional Hospital, Nova Scotia Health Authority

Geriatrician

Geriatric and Memory Disability Clinic, Cape Breton Regional Hospital, Nova Scotia Health Authority

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Published

2020-12-26