b"PACEP SCIENTIFIC ASSEMBLY 2025 CPC HIGHLIGHTThe ConclusionCPC Case Results: CPC CASETest to order: Thyroid peroxidase antibodySTUDYThe Final Diagnosis: RESULTS Hashimotos EncephalopathyPatient Course & Relevance to EMPediatric neurology was consulted. Patient had I s rare but highly treatable thus must be additional testing to rule out other diseasesconsideredwhich were negative. The patient was given IVHigh titers of antithyroid antibodies, in steroids and then discharged on an oral taper.Theparticular antithyroid peroxidase antibodies, patient did not have any signs of systemic hypo/ are diagnostic. These antibodies, however, can hyperthyroidism with normal T3/T4 and TSH.be detected in elevated titers in the healthy The patient was readmitted 13 days aftergeneral populationdischarge with similar complaints and symptoms Thyroid function is usually clinically and and required IVIG 2g/kg divided over 4 days forbiochemically normalrelapse. The patient was restarted on a steroid Normal neuroimaging including CT and MRItaper. On this visit, the patient had an abnormal T4 requiring levothyroxine. CSF analysis with high proteinsThe patient was responsive to steroids andNegative workup for bacterial and viral infection in CSFwas diagnosed with Steroid-Responsive Encephalopathy Associated with autoimmune *** CSF, neuroimaging, EEG do not show Thyroiditis (SREAT)consistent findings for positive diagnostic criteria Hashimoto's encephalopathy is a term used *** Thyroid antibody level does not correlate to describe an encephalopathy of presumedwith severity of diseaseautoimmune origin characterized by high titersof antithyroid peroxidase antibodies. In a similar Must be considered in cases of 'investigation fashion to autoimmune thyroid disease, it is: negative encephalopathies more common in women than in menDiagnosis is made in the first instance by reported in pediatric, adult and elderlyexcluding other toxic, metabolic and infectious populations throughout the world causes of encephalopathy with neuroimaging and CSF examination I nvolves relapsing and improving clinical Highly treatable with positive clinical course outcomes Usually has normal thyroid function both Debilitating symptoms without treatment clinically and biochemically24 PACEP News"