Steroid-Responsive Encephalopathy Associated With Autoimmune Thyroiditis Masquerading Sepsis

Area of Science:

• Neurology
• Immunology
• Endocrinology

Background:

• Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a rare autoimmune neurological disorder.
• It is characterized by fluctuating encephalopathy and elevated antithyroid antibodies.

Observation:

• A 72-year-old male presented with fever and altered mental status, initially suspected as sepsis.
• The patient experienced seizures and neurological decline despite initial treatment.

Findings:

• Extensive workup revealed anti-thyroid peroxidase antibodies, leading to a diagnosis of SREAT.
• The patient demonstrated significant improvement following treatment with glucocorticoids and intravenous immunoglobulins.

Implications:

• SREAT should be considered in the differential diagnosis of unexplained encephalopathy.
• Detection of antithyroid antibodies is crucial for diagnosing SREAT.
• Prompt treatment can lead to favorable neurological outcomes.