Bibliographic record
Abstract
: Hashimoto's encephalopathy is a rare complication of autoimmune thyroid disease with an estimated prevalence of 2.1/100,000.1 It is also known as steroid responsive encephalopathy associated with autoimmune thyroiditis, SREAT.2 The pathogenesis is still unknown, but the possible mechanism could be due to cerebral vasculitis with or without immune complex deposition.3 It is an inflammatory condition proposed by the presence of elevated TPO,4 elevated CSF protein,4 histological feature of vasculitis of venules, and lymphocytic perivascular cuff.1 Patients may present with encephalopathy (100%) which usually develop over 1 to 7 days, tremor (84%), transient aphasia (73%), seizure (66%), gait ataxia (63%), hypersomnolence (63%), myoclonus (38%), neuropsychiatric symptoms (36%), and stroke-like symptoms (27%).1,5 Variable thyroid function tests could be seen in patients with Hashimoto’s encephalopathy despite similar neurological findings. Goiter was found in 63% of the reported cases, subclinical hypothyroidism in 35%, normal thyroid function in 30%, overt hypothyroidism in 20%, and hyperthyroidism in 7% of cases.1,6 Lab tests in patients with Hashimoto’s encephalopathy usually show elevated TPO antibodies (100% of reported cases) and elevated thyroglobulin antibodies in 73% of the reported cases.1,7Upon CSF examination, 78% of the reported cases had elevated protein, and normal leukocyte count in 76% of cases.1,7 The minority of patients, about 15%, had elevated ESR and CRP. Most of the patients (about 98%) with Hashimoto’s encephalopathy had abnormal EEG.7 EEG abnormalities could be generalized slowing, focal slowing, prominent triphasic waves, epileptiform abnormalities, and frontal intermittent rhythmic delta activity.7 50% of the patients with Hashimoto’s encephalopathy had abnormal imaging in CT and MRI, in the form of cerebral atrophy, abnormalities in the white matter and diffused subcortical or focal cortical abnormalities.7,8 Single photon emission computed tomography (SPECT) showed focal hypoperfusion in 73% of cases, global hypoperfusion in 9%, and 18% of cases had normal SPECT. Treatment options include steroids.6 Steroids could be given as oral prednisone (50-100 mg/day), or intravenous methylprednisolone (1 g/day). Thyroid hormone replacement therapy with steroid was administered for patients presenting with hypothyroidism and Hashimoto’s encephalopathy, and there was 92% improvement of reported cases using this combination therapy, and 67% improvement in patients taking levothyroxine alone. There has been only one case having been reported to recover from Hashimoto’s encephalopathy after thyroidectomy.8 Hashimot’s encephalopathy is a rare complication of autoimmune thyroid disease, which is most of the time underdiagnosed. The pathogenesis is still unknown. Steroid is considered the mainstay of treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.005 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.007 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".