{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T04:20:00Z","timestamp":1782966000405,"version":"3.54.5"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T00:00:00Z","timestamp":1738281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Steroid Responsive Encephalopathy Associated with Autoimmune Thyroiditis (SREAT), or Hashimoto\u2019s encephalopathy, is a rare autoimmune neurological disorder linked to elevated antithyroid antibodies and presenting various neurological symptoms. This report deals with a case of a 54-year-old female with a history of hypothyroidism who presented with hypertensive emergency and atypical neurological symptoms that deteriorated during the hospital stay. On testing, she was euthyroid. Initial investigations, including MRI and CSF analysis, were inconclusive, but high levels of antithyroid peroxidase (Anti TPO) antibodies confirmed the diagnosis of SREAT. The patient was managed with intravenous methylprednisolone, leading to rapid clinical improvement. SREAT, being a diagnosis of exclusion, presents with various neurological and neuropsychiatric symptoms that can be difficult to identify. This condition remains poorly understood, though autoimmune factors and antithyroid antibodies seem to play a role. Glucocorticoids remain the primary treatment choice. At the same time, other immunosuppressive agents are reserved for non-responders. This case highlights the critical importance of early diagnosis in SREAT, as early recognition and corticosteroid treatment can lead to significant recovery. Timely intervention is essential for improved patient prognosis, emphasizing the need for awareness of SREAT in patients with a history of hypothyroidism presenting with neurological symptoms.<\/jats:p>","DOI":"10.3389\/fimmu.2025.1504967","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T05:10:31Z","timestamp":1738300231000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["When thyroid met brain: the enigma of steroid responsive encephalopathy associated with autoimmune thyroiditis a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Palash","family":"Kotak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashish","family":"Khurana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarang","family":"Raut","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saket Satyasham","family":"Toshniwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourya","family":"Acharya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/S1474-4422(15)00401-9","article-title":"A clinical approach to the diagnosis of autoimmune encephalitis","volume":"15","author":"Graus","year":"2016","journal-title":"Lancet Neurol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-023-01255-5","article-title":"Hashimoto\u2019s encephalopathy: case series and literature review","volume":"23","author":"Chaudhuri","year":"2023","journal-title":"Curr Neurol Neurosci Rep"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1111\/cen3.12543","article-title":"Hashimoto encephalopathy","volume":"10","author":"Matsunaga","year":"2019","journal-title":"Clin Exp Neuroimmunol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008785","article-title":"Hashimoto encephalopathy in the 21st century","volume":"94","author":"Mattozzi","year":"2020","journal-title":"Neurology"},{"key":"B5","doi-asserted-by":"publisher","first-page":"101364","DOI":"10.1016\/j.beem.2019.101364","article-title":"Thyroid gland and brain: Enigma of Hashimoto\u2019s encephalopathy","volume":"33","author":"Churilov","year":"2019","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/ane.12618","article-title":"Hashimoto encephalopathy: literature review","volume":"135","author":"Zhou","year":"2017","journal-title":"Acta Neurol Scand"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2016.09.008","article-title":"Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT): Characteristics, treatment and outcome in 251 cases from the literature","volume":"15","author":"Laurent","year":"2016","journal-title":"Autoimmun Rev"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/BF00900946","article-title":"Encephalopathy associated with Hashimoto thyroiditis: Diagnosis and treatment","volume":"243","author":"Kothbauer-Margreiter","year":"1996","journal-title":"J Neurol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.aace.2023.10.001","article-title":"Encephalopathy of autoimmune origin: steroid-responsive encephalopathy with associated thyroiditis","volume":"9","author":"Adithya-Sateesh","year":"2023","journal-title":"AACE Clin Case Rep"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.2.197","article-title":"Steroid-responsive encephalopathy associated with autoimmune thyroiditis","volume":"63","author":"Castillo","year":"2006","journal-title":"Arch Neurol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1001\/jamapsychiatry.2018.0190","article-title":"Association of depression and anxiety disorders with autoimmune thyroiditis: A systematic review and meta-analysis","volume":"75","author":"Siegmann","year":"2018","journal-title":"JAMA Psychiatry"},{"key":"B12","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1001\/archneur.60.2.164","article-title":"Hashimoto encephalopathy: syndrome or myth","volume":"60","author":"Chong","year":"2003","journal-title":"Arch Neurol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-510X(00)00302-6","article-title":"Encephalopathy associated to autoimmune thyroid disease: a more appropriate term for an underestimated condition","volume":"176","author":"Cant\u00f3n","year":"2000","journal-title":"J Neurol Sci"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000048660.71390.C6","article-title":"Antithyroid antibodies in the CSF: Their role in the pathogenesis of Hashimoto\u2019s encephalopathy","volume":"60","author":"Ferracci","year":"2003","journal-title":"Neurology"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00521","article-title":"Thyroid autoimmunity: role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases","volume":"8","author":"Fr\u00f6hlich","year":"2017","journal-title":"Front Immunol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1504967\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T05:10:33Z","timestamp":1738300233000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2025.1504967\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,31]]},"references-count":15,"alternative-id":["10.3389\/fimmu.2025.1504967"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2025.1504967","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,31]]},"article-number":"1504967"}}