Presentation
A 37-year-old woman presented with a history of gradual onset of fatigue, myalgia, low grade fever, and neck pain. [researchers.mq.edu.au]
The present study describes in depth a case of Riedel thyroiditis (RT) to clarify its pathogenesis and its putative inclusion in the spectrum of IgG4-related disease. [ncbi.nlm.nih.gov]
It is our ambition to present a complete survey of all medical phenomena named for a person, with a biography of that person. Disclaimer: Whonamedit? does not give medical advice. [whonamedit.com]
Entire Body System
- Goiter
The clinical manifestations of RT are protean, often resembling malignancy owing to goiter of remarkably hard consistency. [ncbi.nlm.nih.gov]
Riedel Thyroiditis is a rare form of infiltrative and fibrotic disease of the thyroid that is characterized by compressive symptoms resulting from a rapidly enlarging goiter. [endocrine-abstracts.org]
[…] sites of involvement Only retroperitoneal fibrosis linked to possible etiologic agent (i.e., methysergide) CLINICAL ISSUES Epidemiology Incidence Uncommon disease Age Primarily occurs in adults Gender Female > Male Presentation Painless neck mass &/or goiter [basicmedicalkey.com]
- Pseudotumor
The terms retroperitoneal fibrosis, mediastinal fibrosis, sclerosing cholangitis, Riedel's sclerosing thyroiditis, and pseudotumor of the orbit reflect the multiple areas involved. [annals.org]
[…] thyroiditis Epidemiology Slight female predominance, usually age 40 - 60 years Clinical features Associated with inflammatory fibrosclerosis / multifocal systemic fibrosclerosis (mediastinal or retroperitoneal fibrosis, sclerosing cholangitis, inflammatory pseudotumor [pathologyoutlines.com]
Varying combinations of involvement have been reported: Riedel's thyroiditis, retroperitoneal fibrosis, orbital pseudotumor, mediastinal fibrosis, and sclerosing cholangitis (1–4). [ajnr.org]
These manifestations can include the following: Retroperitoneal fibrosis Mediastinal fibrosis Orbital pseudotumor Pulmonary fibrosis Sclerosing cholangitis Lacrimal gland fibrosis Fibrosing parotitis Diagnosis A tissue sample is needed to diagnose Riedel [thyroid.com.au]
Pseudotumor of the maxillary antrum. J. Laryngol. Otol. 104 : 244, 1990. PubMed CrossRef Google Scholar 21. Sclare G., Luxton W. Fibrosis of the thyroid and lacrimal glands. Br. J.Ophtalm. 51 : 173, 1967. CrossRef Google Scholar 22. [link.springer.com]
- Painless Jaundice
Painless jaundice with serial multi-organ dysfunction. Lancet. 2009 Apr 25. 373(9673):1494. [Medline]. Drieskens O, Blockmans D, Van den Bruel A, et al. [emedicine.medscape.com]
- Weight Gain
[…] versions of USMLE-Endocrine and pathology III : main | yours | all Section 1 Question Answer signs/sx of hypothyroidism : cold intolerance (diminution of heat production) signs/sx of hypothyroidism : weight gain, diminution of appetite signs/sx of hypothyroidism [memorize.com]
This phase can be characterized by a slight enlargement of the thyroid gland and symptoms of weight gain, fatigue, lack of energy and often depression. [columbiasurgery.org]
• Weight gain • Heavy menstrual flow 11. [de.slideshare.net]
Respiratoric
- Stridor
[…] systemic disease that can affect many organ systems called “IgG4 – related disease” Symptoms 4) Medscape – Riedel’s Thyroiditis Airway obstruction Dysphonia Hoarseness (due to recurrent laryngeal involvement) Hypothyroidism Hypoparathyroidism Dysphagia Stridor [meddiction.com]
As with other thyroid disorders, there may be symptoms from local compression such as dysphagia or stridor. On examination, there is usually a thyroid goiter which is fixed and hard, sometimes described as stony or woody. [radiopaedia.org]
Complications Airway obstruction Dysphonia Hoarseness - Due to recurrent laryngeal involvement Hypothyroidism Hypoparathyroidism Dysphagia Stridor - Due to tracheal compression Incidence The overall incidence among outpatients was 1.6 cases per 100,000 [thyroiduk.org.uk]
[…] etiologic agent (i.e., methysergide) CLINICAL ISSUES Epidemiology Incidence Uncommon disease Age Primarily occurs in adults Gender Female > Male Presentation Painless neck mass &/or goiter Pressure in anterior neck often associated with dysphagia, dyspnea, stridor [basicmedicalkey.com]
Complications of Riedel thyroiditis can include the following: Airway obstruction Dysphonia Hoarseness – Due to recurrent laryngeal involvement Hypothyroidism Hypoparathyroidism Dysphagia Stridor – Due to tracheal compression Associated Clinical Features [thyroid.com.au]
Eyes
- Lacrimation
It is sometimes considered as a manifestation of a wider systemic disease with fibrosis of the retroperitoneum, mediastinum, as well as lymphocytic infiltration of extraocular orbital muscles, salivary and lacrimal glands 4. [radiopaedia.org]
[…] evidence suggests RT part of IgG4-related systemic disease spectrum Characterized by IgG4(+) plasma cell infiltration and fibrosis in many organs Systemic disease may include Retroperitoneum, mediastinum, retro-orbit, lung, sinonasal tract, parotid gland, lacrimal [basicmedicalkey.com]
These manifestations can include the following: Retroperitoneal fibrosis Mediastinal fibrosis Orbital pseudotumor Pulmonary fibrosis Sclerosing cholangitis Lacrimal gland fibrosis Fibrosing parotitis Diagnosis A tissue sample is needed to diagnose Riedel [thyroid.com.au]
Fibrosis of the thyroid and lacrimal glands. Br. J.Ophtalm. 51 : 173, 1967. CrossRef Google Scholar 22. Miro I., Bakir R., Chanu B., Brocheriou C., Brenot F., Rouffy J. Thyroídite de Riedel et fibrose rétropéritonéale. Ann. Med. [link.springer.com]
These manifestations can include the following [8] : Retroperitoneal fibrosis Mediastinal fibrosis Orbital pseudotumor Pulmonary fibrosis Sclerosing cholangitis Lacrimal gland fibrosis Fibrosing parotitis Riedel BM. [emedicine.medscape.com]
Workup
(See Etiology and Workup.) Gross pathology of Riedel thyroiditis. The cut edge is avascular, with a characteristic white color. Image courtesy of SL Lee. Involvement in RT may be unilateral or bilobar. [emedicine.com]
Treatment
Riedel’s Thyroiditis Treatment Therapy usually consists of prednisone. Tamoxifen has been proposed as part of a treatment plan. Nonetheless some patients may require surgery. Treatment is directed to surgical relief of compressive symptoms. [thyroid.com.au]
Our report indicates that tamoxifen can be a valuable drug therapy in the treatment of Riedel's thyroiditis. [ncbi.nlm.nih.gov]
Treatment The treatment of acute thyroiditis is focused on eliminating the infection and reducing symptoms while the infection resolves. [verywell.com]
Surgical Treatment for Riedel’s Thyroiditis: a Case Report © 2017 Korean Thyroid Association. [ijthyroid.org]
Make the best clinical decisions with an enhanced emphasis on evidence-based practice and expert opinions on treatment strategies. Zero in on the most relevant and useful references with the aid of a more focused, concise bibliography. [books.google.de]
Prognosis
In the same study, the mean age at diagnosis of RT was 47.8 years (range, 23-77 y). [3] Prognosis Riedel thyroiditis (RT) is generally a self-limited disease with a favorable prognosis. [emedicine.com]
Etiology
The present article reviews the most recent concepts about etiologic mechanisms, pathogenesis, diagnosis, and management of RT. [ncbi.nlm.nih.gov]
However, IgG4-RSD may unify these 2 seemingly disparate etiologies. [emedicine.com]
Epidemiology
[…] inflammatory process involving thyroid gland and adjacent neck tissue Described in 1896 by German surgeon Bernhard Moritz Carl Ludwig Riedel ( Wikipedia ) Rare (0.05% of thyroidectomy specimens) Terminology Also called Riedel struma, fibrous thyroiditis Epidemiology [pathologyoutlines.com]
[…] tract, parotid gland, lacrimal gland, hepatobiliary tract (sclerosing cholangitis) RT may coexist with one or more of these other sites of involvement Only retroperitoneal fibrosis linked to possible etiologic agent (i.e., methysergide) CLINICAL ISSUES Epidemiology [basicmedicalkey.com]
EPIDEMIOLOGY Women are three to five times more likely to be affected than men. [aafp.org]
The disorders are characterized by lymphoplasmacytic infiltrates containing IgG4-positive plasma cells. [5] These infiltrates ultimately lead to fibrosis and elevated serum levels of IgG4. [6, 7] Epidemiology United States Riedel thyroiditis (RT) is a [emedicine.com]
Pathophysiology
Pathophysiology 2) Wikipedia – Riedel’s Thyroiditis Fibrotic encroachment beyond the thyroid capsule Riedel’s thyroiditis is characterized by a replacement of the normal thyroid parenchyma by a dense fibrosis that invades adjacent structures of the neck [meddiction.com]
Understanding the pathophysiological relationship of this entity with other forms of systemic fibrosis and the role that IgG4 may play in this process should result in enhanced diagnostic and therapeutic tools in the future. [ncbi.nlm.nih.gov]
IgG4 is also involved in the pathophysiology of other autoimmune disorders including anti-ADAMTS13 autoantibodies in thrombotic thrombocytopenic purpura and anti-M-type phospholipase A2 receptor autoantibodies in idiopathic membranous glomerulonephritis [edmcasereports.com]
Although IgG4-related Hashimoto’s thyroiditis and Riedel’s thyroiditis are two distinct entities, they share the pathophysiology of IgG4-related disease. [nature.com]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.de]
Surgery was performed to obtain a definitive diagnosis and prevent the possibility of subsequent additional tracheal compression with airway compromise. [jamanetwork.com]