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Riedel’s Thyroiditis

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

References

  1. Jump up ^John H. Stone, Yoh Zen, Vikram Deshpande (February 2012). “IgG4-Related Disease”. New England Journal of Medicine 336 (6): 539–51. doi:10.1056/NEJMra1104650. PMID22316447.
  2. Jump up ^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. PMID17603227. CS1 maint: Explicit use of et al. (link)[dead link]
  3. Jump up ^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. PMID6195075.

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