Initial serum thyroid peroxidase antibodies and long-term outcomes in SREAT

There is very little clear evidence that antibodies (of any sort) have a direct effect.

This paper doesn't go so far as to prove details but does enough to raise questions and point directions.

(SREAT is also called Hashimoto's Encephalopathy. It has been suggested to be related to increased Thyroid Peroxidase antibodies in cerebro-spinal fluid.)

Acta Neurol Scand. 2016 Jan 12. doi: 10.1111/ane.12556. [Epub ahead of print]

Initial serum thyroid peroxidase antibodies and long-term outcomes in SREAT.

Litmeier S1, Prüss H1,2, Witsch E3, Witsch J1.

Author information

1 Department of Neurology, Charité University Medicine Berlin, Berlin, Germany.

2 German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany.

3 Department of Neurology, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany.

Abstract

OBJECTIVE:

To quantify clinical outcome in patients with steroid-responsive encephalopathy and associated autoimmune thyroiditis (SREAT) after the acute phase and explore potential associations of initial serum thyroid peroxidase antibody titers (TPO-Abs) with outcome.

MATERIALS AND METHODS:

Retrospective chart review of patients diagnosed with SREAT between 01/2005 and 05/2014 in a tertiary care center and followed in an affiliated autoimmune outpatient clinic. Outcome was quantified using the extended Glasgow Outcome Scale (GOS-E). We calculated Pearson's correlation coefficients to quantify associations with clinical outcome at follow-up.

RESULTS:

Among 134 patients with encephalopathy of unknown etiology, we identified 13 patients diagnosed with SREAT. In two patients, the diagnosis was revised at subsequent hospitalization (NMDA-R encephalitis and adult-onset Still's disease). The median follow-up time was 11 months, and the median GOS-E was 6 (range 3-8). Higher serum TPO-Ab-titers correlated with more favorable outcomes (Pearson coefficient 0.65, P = 0.03).

CONCLUSION:

A correlation between TPO-Ab-titers and outcome has not been reported previously and challenges the notion of a mere bystander role of TPO-Abs in SREAT.

© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

KEYWORDS:

SREAT ; autoantibodies; autoimmune diseases; encephalitis; hashimoto encephalopathy; steroid-responsive encephalopathy; thyroid microsomal antibodies; thyroid peroxidase antibodies

PMID: 26757046 [PubMed - as supplied by publisher]

ncbi.nlm.nih.gov/pubmed/267...

A bit of information about SREAT:

thyroid.about.com/od/relate...

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