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Case report
Hashimoto’s encephalopathy: a rare cause of delirium
  1. Osakpolor Ogbebor and
  2. Kavya Patel
  1. Internal Medicine, Saint Peter’s University Hospital, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Osakpolor Ogbebor, osakpolor.ogbebor{at}


Cognitive impairment is a frequent presentation of patients who come to the hospital. We report a case of a patient who presents with a common symptom, however, with a rare disease. This is an 84-year-old woman with a history of hypertension and atrial fibrillation who was reported to have confusion of 3 weeks. Investigations, including a complete blood count, MRI imaging of the brain, cerebrospinal fluid analysis and paraneoplastic screen, were all negative. Of note, thyroid peroxidase antibody was elevated. She did not have a history of thyroid disease. Following this, an assessment of Hashimoto encephalopathy was made. She was started on steroids and she showed remarkable recovery within 2 months, therefore, confirming the diagnosis. This case report emphasises the need to consider Hashimoto’s encephalopathy as a differential for delirium especially when other common aetiologies have been ruled out.

  • dementia due to medical condition
  • neuroendocrinology
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  • Contributors OO and KP were involved in managing the patient when she was admitted. Both authors were involved in writing the case description and were involved in literature search and subsequently writing the discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Next of kin consent obtained.

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