title: Autoimmune encephalopathy associated with thyroid autoantibodies as the cause of reversible cognitive impairment.
abstract: We herewith describe a patient with acute confusion, expressive aphasia and generalized seizures. A through workup excluded most causes of encephalopathy. He was, however, found to have TSH=18.6 MIU/ml, T3reverse=0.44nmol/L, T4=0.8ng/dl and Anti-Thyroid-Peroxidase AB titer >1000 IU/ml. Based on the above findings the patient was diagnosed with Hashimoto's encephalopathy and his mental status showed dramatic improvement (MMS 30/30) with high dose prednisone. Hashimoto's encephalopathy is rare disorder of presumed autoimmune origin characterized by cognitive decline, seizures, neuro-psychiatric symptoms, high titers of Anti-Thyroid-Peroxidase AB, and a positive response to steroids.
authors.affiliation: Department of Medicine, Good Samaritan Hospital of Maryland, Baltimore, MD, USA ; Division of Nephrology, Hypertension and Renal Transplantation University of Florida, Gainesville, FL, USA.
authors.forename: Natallia
authors.initials: N
authors.lastname: Maroz
authors.forename: Nechama
authors.initials: N
authors.lastname: Bernhardt
authors.forename: Robert Dobbin
authors.initials: RD
authors.lastname: Chow
keywords: autoimmune encephalopathy; hashimoto; reversible cognitive impairment; thyroid-peroxidase antibody