Hashimoto’s Encephalopathy: A Rare Clinical Diagnosis in a Male Pediatric Patient

Hashimoto's encephalopathy (HE) is very uncommon in the pediatric literature. It is most often characterized by altered mental status (AMS) that can range from mild confusion to hallucinations and severe agitation. The exact pathophysiologic mechanism of HE is unclear. The most popular proposed mechanism describes an immune-mediated process as opposed to a direct effect of thyroid hormone or thyroid antibodies on the central nervous system (CNS) despite the association in the name with Hashimoto's thyroiditis. Suspicion for HE is raised when a patient has encephalopathy, the presence of thyroid antibodies, and responsiveness to high-dose corticosteroids.