The exact role of antithyroid antibodies in Hashimoto’s
encephalopathy is unclear. While most patients with (HE) will
eventually be diagnosed with Hashimoto’s thyroiditis, the former can
precede the latter by several years [4]. Tissue pathology from both of
our patients revealed cellular changes very similar to those found in
Hashimoto’s thyroiditis (Figure 1 and 2). Both cases are examples of
tissue changes in the thyroid preceding the onset of altered thyroid
hormone levels or clinical symptoms.