Possible Steroid-responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) in a Patient with Impaired Consciousness

Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), also known as Hashimoto’s encephalopathy (HE) is a rare neurological disorder associated with thyroid autoimmunity. Clinical manifestations include seizures, altered consciousness, transient aphasia, tremors, myoclonus, cognitive impairment, and psychiatric manifestations. Here, we report a case of a 55-year-old female presenting with altered sensorium for 4 days. The patient was a known case of Hypothyroidism, Hypertension and Diabetes. Serologic studies demonstrated elevated levels of anti-thyroid peroxidase (anti-TPO) antibodies. The patient showed a remarkable response to steroid therapy. Hence, the diagnosis of SREAT should be suspected in cases of encephalopathy without an obvious cause, as a good response can be obtained withsteroid therapy; early diagnosis and treatment are very beneficial for such patients.