Riedel's thyroiditis

Riedel's thyroiditis, is a chronic form of thyroiditis. It is now believed that Riedel's thyroiditis is one manifestation of a systemic disease that can affect many organ systems called IgG4-related disease. It is often a multi-organ disease affecting pancreas, liver, kidney, salivary and orbital tissues and retroperitoneum. The hallmarks of the disease are fibrosis and infiltration by IgG4 secreting plasma cells.[1]

Riedel's thyroiditis
Other namesRiedel's struma
SpecialtyEndocrinology 

Pathophysiology

Riedel's thyroiditis is characterized by a replacement of the normal thyroid parenchyma by a dense fibrosis that invades adjacent structures of the neck and extends beyond the thyroid capsule.[2] This makes the thyroid gland stone-hard (woody) and fixed to adjacent structures. The inflammatory process infiltrates muscles and causes symptoms of tracheal compression. Surgical treatment is required to relieve tracheal or esophageal obstruction.

Diagnosis

Diagnosis is done by biopsy

Treatment

Therapy usually consists of prednisolone, nonetheless some cases may require surgery. Tamoxifen has been proposed as part of a treatment plan.[3]

Treatment is directed to surgical relief of compressive symptoms. Tamoxifen may also be beneficial. The type of surgery which is indicated here is isthmectomy.

Prevalence

Riedel's thyroiditis is classified as rare.[4] Most patients remain euthyroid, but approximately 30% of patients become hypothyroid and very few patients are hyperthyroid. It is most commonly seen in women.[5]

Eponym

It is named for Bernhard Riedel. He first recognized the disease In 1883 and published its description in 1896.[6][7]

References
  1. John H. Stone; Yoh Zen; Vikram Deshpande (February 2012). "IgG4-Related Disease". New England Journal of Medicine. 366 (6): 539–51. doi:10.1056/NEJMra1104650. PMID 22316447.
  2. Cho MH, Kim CS, Park JS, et al. (August 2007). "Riedel's thyroiditis in a patient with recurrent subacute thyroiditis: a case report and review of the literature". Endocr. J. 54 (4): 559–62. doi:10.1507/endocrj.K06-186. PMID 17603227.
  3. Dabelic N, Jukic T, Labar Z, Novosel SA, Matesa N, Kusic Z (April 2003). "Riedel's thyroiditis treated with tamoxifen" (PDF). Croat. Med. J. 44 (2): 239–41. PMID 12698518.
  4. Harach, HR; Williams, ED (Sep 1983). "Fibrous thyroiditis--an immunopathological study". Histopathology. 7 (5): 739–51. doi:10.1111/j.1365-2559.1983.tb02286.x. PMID 6195075.
  5. eMedicine
  6. B. M. C. L. Riedel. Die chronische, zur Bildung eisenharter Tumoren führende Entzündung der Schilddrüse. Verhandlungen der deutschen Gesellschaft für Chirurgie, 1896, 25: 101-105.
  7. synd/3242 at Who Named It?
Classification
External resources
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