title: Steroid-responsive depression.
abstract: A 48-year-old man presented with long-standing symptoms of major depression in the absence of markedly abnormal neurological findings or structural brain alterations. Antidepressive treatment, including medication and psychotherapy, had not led to significant improvement. The EEG, cerebrospinal fluid (CSF) analysis, fluorodeoxyglucose-positron emission tomography and neuropsychological testing showed pathological findings. An epileptic state provided further evidence for an organic encephalopathy. Extensively elevated thyroid-antibodies in the serum and CSF, as well as the rapid and sustained recovery after intravenous treatment with prednisolone, pointed to the diagnosis of a primarily psychiatric manifestation of a steroid responsive encephalopathy associated with autoimmune thyroiditis (SREAT).
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Normann
authors.forename: Lukas
authors.initials: L
authors.lastname: Frase
authors.forename: Mathias
authors.initials: M
authors.lastname: Berger
authors.forename: Christoph
authors.initials: C
authors.lastname: Nissen
mesh_terms: D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000209:etiology*; D003937:Diagnosis, Differential; D004569:Electroencephalography; D004660:Encephalitis; D005938:Glucocorticoids / Q000627:therapeutic use*; D050031:Hashimoto Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D049268:Positron-Emission Tomography; D011239:Prednisolone / Q000627:therapeutic use*
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone