Steroid-responsive encephalopathy associated with autoimmune thyroiditis presenting with a postpartum psychosis

Area of Science:

• Neurology
• Endocrinology
• Psychiatry

Background:

• Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) presents with neuropsychiatric symptoms and responds to steroids.
• Postpartum psychosis (PP) is a psychiatric emergency with potential autoimmune links, often presenting atypically.

Observation:

• A young primiparous woman experienced postpartum psychosis refractory to antipsychotic treatment.
• SREAT was considered in the differential diagnosis after initial treatment failure.

Findings:

• High-dose steroid treatment led to dramatic improvement in neuropsychiatric symptoms within 72 hours.
• The patient recovered and was discharged after 16 days of hospitalization.

Implications:

• Autoimmune causes like SREAT should be investigated in postpartum psychosis cases unresponsive to standard psychiatric treatment.
• Considering SREAT can expedite diagnosis and facilitate effective steroid-based therapy, improving maternal and child outcomes.