Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Fever and Confusion
Joint Authors
Liyanage, Chiranthi Kongala
Munasinghe, Tilak Manthi Janake
Paramanantham, Adsareswary
Source
Case Reports in Neurological Medicine
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-4, 4 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-11-06
Country of Publication
Egypt
No. of Pages
4
Main Subjects
Abstract EN
Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT) is a diagnostic conundrum as it may present with a myriad of nonspecific clinical features and laboratory and neuroimaging investigations are not diagnostic.
We report a case of a 65-year-old female who presented with an acute febrile illness associated with headache and confusion, tangential thoughts, and loose association.
Based on neutrophil leukocytosis in the full blood count and elevated inflammatory markers, she was commenced on empirical intravenous antibiotics suspecting meningoencephalitis.
Further evaluation found a very high titer of both anti-thyroid peroxidase (anti-TPO) antibodies and anti-thyroid globulin antibodies.
She was clinically and biochemically euthyroid.
EEG showed right sided frontal intermittent rhythmic delta activity (FIRDA).
Cranial MRI revealed age related cerebral atrophy and nonspecific periventricular white matter changes.
A diagnosis of SREAT was made and she was treated with intravenous methylprednisolone followed by oral prednisolone.
Her condition improved dramatically within 48 hours of starting steroids.
SREAT is a diagnosis of exclusion in patients with a central nervous system disorder.
There are no specific clinical features or investigative findings.
Elevated anti-TPO antibodies are considered a hallmark of SREAT and steroid responsiveness supports the diagnosis.
Prompt diagnosis and treatment reverses the neurological dysfunction in most cases.
American Psychological Association (APA)
Liyanage, Chiranthi Kongala& Munasinghe, Tilak Manthi Janake& Paramanantham, Adsareswary. 2017. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Fever and Confusion. Case Reports in Neurological Medicine،Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1147129
Modern Language Association (MLA)
Liyanage, Chiranthi Kongala…[et al.]. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Fever and Confusion. Case Reports in Neurological Medicine No. 2017 (2017), pp.1-4.
https://search.emarefa.net/detail/BIM-1147129
American Medical Association (AMA)
Liyanage, Chiranthi Kongala& Munasinghe, Tilak Manthi Janake& Paramanantham, Adsareswary. Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Fever and Confusion. Case Reports in Neurological Medicine. 2017. Vol. 2017, no. 2017, pp.1-4.
https://search.emarefa.net/detail/BIM-1147129
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1147129