Riedel's thyroiditis
| Riedel's thyroiditis | |
|---|---|
| Other names | Riedel's struma |
| Specialty | Endocrinology  |
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]
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.[citation needed]
Diagnosis
Diagnosis is done by biopsy[citation needed]
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. [citation needed]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
- ^ 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.
- ^ 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.
- ^ 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.
- ^ 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.
- ^ eMedicine
- ^ 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.
- ^ synd/3242 at Who Named It?