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AJNR - American Journal of Neuroradiology

Published ahead of print on August 13, 2008
doi: 10.3174/ajnr.A1113

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American Journal of Neuroradiology 29:1550-1551, September 2008
© 2008 American Society of Neuroradiology

Case Report
BRAIN

Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis Presenting with Diffusion MR Imaging Changes

C. Grommes^a, C. Griffin^a, K.A. Downes^b and A.J. Lerner^a

^a Departments of Neurology, University Hospitals Case Medical Center, Cleveland, Ohio
^b Departments of Pathology, University Hospitals Case Medical Center, Cleveland, Ohio

Please address correspondence to Alan J. Lerner, Department of Neurology, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH 44106; e-mail: alan.lerner{at}UHhospitals.org

SUMMARY: Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) presents with focal or diffuse nonenhancing MR imaging abnormalities in 50% of patients with SREAT during subacute exacerbation. Vasculitic changes in biopsy studies as well as the elevation of antithyroid antibodies and CSF protein suggests an inflammatory cause. We report the case of a patient with SREAT with changes on diffusion-weighted MR imaging, which improved with corticosteroid therapy and plasmapheresis, supporting the theory of inflammatory changes in exacerbation of presumptive SREAT.