One female patient with paranoid-hallucinatory syndrome and anti-TPO antibodies, with EEG slowing, increased albumin quotient, and cMRI atrophy responded well to steroids and was therefore re-diagnosed with Hashimoto encephalopathy (the diagnosis was already made 2017, in 2018 the symptomatology worsened again, which is why the patient was again treated as an inpatient). Here, TPO is linked to hereditary elliptocytosis.