The exact cause of HE/SREAT is as yet unknown.
We do know that in patients with HE/SREAT, “antithyroid antibodies … are the hallmark of this disease.”1 High serum (blood) antibody titers for thyroid peroxidase (TPO) or other anti-thyroid antibodies are found. The exact correlation or pathogen is not currently known.2
The current accepted theory is that HE/SREAT is an autoimmune condition. While further research is still pending, Japanese research has turned up the presence of antibodies to alpha-enolase (serum autoantibodies against the NH2-terminal of a-enolase3,4,5) in addition to the presense of other anti-thyroid antibodies in the serum. At this time, this research is limited.
While at this time there is no difinitive diagnostic criteria for HE/SREAT itself, in February of 2016 Dr. Josep Dalmau et. al published the first broadly accepted criteria for diagnosing autoimmune encephalitis in the publication, The Lancet. This important paper includes ground-breaking guidelines for the diagnosis of antibody negative autoimmune encephalopathies (of which HE/SREAT is believed to be one due to the indefinate presense of a unique antibody).
While it is not known at this time how widely this criteria will be used in diagnosing HE/SREAT in the United States, it is an important contribution to the diagnosis of autoimmune encephalitis and encephalopathies. The article is entitled, “A clinical approach to the diagnosis of autoimmune encephalitis“, and is available for purchase online via The Lancet.
3 “Hashimoto’s encephalopathy as a treatable adult-onset cerebellar ataxia mimicking spinocerebellar degeneration.”
Matsunaga, Akiko, Masamichi Ikawa, Akihiro Fujii, Yasunari Nakamoto, Masaru Kuriyama, and Makoto Yoneda.
201 Vol.69, No.1 pg 14-20
Last edited by Web Team on June 20th, 2016