The Third Time's the Charm

Sara Mekuria*, Esteban Cheng Ching, S. A. Josephson, Jinny Tavee, Brian J. Harte

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter


Hashimoto's encephalopathy (HE) is an uncommon condition that can present with a rapidly progressive decline and should be considered in patients who present with recurrent mental status changes in the setting of normal imaging studies and routine laboratory results. The entity, in the most recent terminology, is known as steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). It is characterized by an acute or subacute encephalopathy associated with thyroid autoimmunity. Patients typically present with fluctuating symptoms, episodes of confusion, alterations of consciousness, and rapid cognitive decline. Different approaches to the treatment of HE have been recommended. As the acronym SREAT suggests, patients typically respond dramatically to high-dose steroid therapy.

Original languageEnglish (US)
Title of host publicationClinical Care Conundrums
Subtitle of host publicationChallenging Diagnoses in Hospital Medicine
PublisherJohn Wiley and Sons
Number of pages9
ISBN (Print)9780470905654
StatePublished - Mar 21 2013


  • Autoimmune encephalopathies
  • Cognitive deterioration
  • Corticosteroids
  • Hashimoto's encephalopathy (HE)
  • Steroid-responsive encephalopathy associated with autoimmune thyroiditis
  • Thyroid autoimmunity

ASJC Scopus subject areas

  • Medicine(all)

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