Riedel's thyroiditis

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Riedel's thyroiditis
Classification and external resources
ICD-10 E06.5
ICD-9 245.3
DiseasesDB 11590
eMedicine med/2036

Riedel's thyroiditis, also called Riedel's struma 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]

Pathophysiology[edit]

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 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.


Prevalence[edit]

Riedel's thyroiditis is classified as rare.[3] Most patients remain euthyroid, but approximately 30% of patients become hypothyroid and very few patients are hyperthyroid. It is most seen in women.[4]

Treatment[edit]

Therapy usually consists of prednisone(?), nonetheless some cases may require surgery. Tamoxifen has been proposed as part of a treatment plan.[5]

Treatment is directed to surgical relief of compressive symptoms. Tamoxifen may also be beneficial. -Harrison's principle of internal medicine, 17th

The type of surgery which is indicated here is isthmectomy.

Eponym[edit]

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

References[edit]

  1. ^ Stone JH (February 2012). "IgG4-Related Disease". New England Journal of Medicine 336 (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" (– Scholar search). Endocr. J. 54 (4): 559–62. doi:10.1507/endocrj.K06-186. PMID 17603227. [dead link]
  3. ^ 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. 
  4. ^ eMedicine
  5. ^ 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. 
  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?

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