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Riedel Thyroiditis
IgG4-Related Thyroid Disease

Presentation

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]

The aim of this presentation is to report a patient with asymptomatic Riedel Thyroiditis associated with Thyroid Storm and Polyglandular Autoimmune Disease. [endocrine-abstracts.org]

Entire Body System

  • Inflammation

    […] destruction of the thyroid takes place … Dictionary of molecular biology thyroiditis — noun Inflammation of the thyroid gland … Wiktionary [translate.academic.ru]

    A thyroiditis Hashimoto’s usually starts without symptoms clear; it may even be that the patient suffered for years a chronic inflammation of the thyroid without realizing it. [health.cytan.com]

    More than 80 % of the left thyroid lobe was effaced by fibrosis and inflammation (lymphocytes, 57 IgG4+ plasma cells per 1 high-power field, an IgG4/IgG ratio of 0.67, and eosinophils) with extension into the surrounding tissues and occlusive phlebitis [ncbi.nlm.nih.gov]

    The mean number of IgG4 + cells/ HPF, normalized to the degree of inflammation, was 3·2 ± 3·0 SD (RT) vs 0·9 ± 0·7 (HT), P = 0·15, for fibrotic areas and 2·1 ± 2·3 SD vs 1·0 ± 0·8 (P = 0·39) for areas with lymphoid aggregates. [mayoclinic.pure.elsevier.com]

    Published September 13, 2012 by Thyroiditis is inflammation of thyroid gland. Most often it results from an infective or autoimmune process. [tandurust.com]

  • 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]

    DD • Euthyroid Sick Syndrome • Goiter • Goiter, Diffuse Toxic • Goiter, Lithium-Induced • Goiter, Nontoxic • Goiter, Toxic Nodular • Hypopituitarism (Panhypopituitarism) • Polyglandular Autoimmune Syndrome, 12. [slideshare.net]

  • Pain

    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]

    Symptoms may include: Rapid onset of pain and tenderness in one side of your neck Fever and chills (a flu-like feeling) Enlarged thyroid gland or an enlargement in your neck area A movable lump in your neck A warm, red, or tender area in the neck Painful [verywell.com]

    Case 10: Back pain Case 11: Dark stools Case 12: Chest pain Case 13: Chest pain Case 14: Chest pain Case 15: Chronic abdominal pain Case 16: Trouble sleeping Case 17: Forgetfulness Case 18: Cough Case 19: Cough Case 2: Abdominal pain Case 20: Decreased [amboss.com]

    Thyroidal pain • anti-inflamatory medications such as aspirin. • steroid therapy with prednisone. 35. [slideshare.net]

  • Fever

    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]

    This type of infection is painful, associated with a fever, and progresses rapidly. It can affect children and adults, but it is more common among children. [verywell.com]

    Case 33: Headache Case 34: Vision loss Case 35: Heartburn Case 36: Fatigue Case 37: Skin changes Case 38: Ankle pain Case 39: Shoulder pain Case 4: Vaginal bleeding Case 40: Dizziness Case 5: Nausea Case 6: Pelvic pain Case 7: Toddler with a cough and fever [amboss.com]

    SX: - Subacute thyroiditis begins with a prodrome of generalized myalgias, pharyngitis, low-grade fever, and fatigue. - Patients then present with fever and severe neck pain, swelling, or both. - Up to 50 percent of patients have symptoms of thyrotoxicosis [enotes.tripod.com]

    CASE REPORT A 48-year-old woman visited our hospital due to abdominal pain and fever of 3 days' duration. She received antibiotic treatment under the diagnosis of cholecystitis with gallstones and liver cirrhosis. [kjim.org]

  • 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. [slideshare.net]

Gastrointestinal

  • Vomiting

    A 54-year-old female patient with recent diagnosis of Grave’s Disease was admitted to our hospital with congestive heart failure, abdominal pain, vomiting and diarrhea. [endocrine-abstracts.org]

    You may need treatment with an intravenous (IV) antibiotic if your doctor is concerned that your infection is progressing rapidly, if you can't swallow oral medication, or if you are vomiting so much that you can't absorb oral medication. [verywell.com]

  • Nausea

    Case 30: Sore throat Case 31: Cough Case 32: Genital lesion Case 33: Headache Case 34: Vision loss Case 35: Heartburn Case 36: Fatigue Case 37: Skin changes Case 38: Ankle pain Case 39: Shoulder pain Case 4: Vaginal bleeding Case 40: Dizziness Case 5: Nausea [amboss.com]

Liver, Gall & Pancreas

  • 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]

    Insulin Insulinoma Internal hernia Interstitial lung disease Intestinal ischemia Intracerebral hemorrhage Intrauterine growth restriction Intravenous anaesthetics Intussusception Iron deficiency anemia Irritable bowel syndrome Japanese encephalitis Jaundice [amboss.com]

Neurologic

  • Tremor

    Clinical symptoms of hyperthyroidism include tachycardia, nervousness, tremor, sweating, heat intolerance, proximal muscle weakness, frequent bowel movements, decreased exercise tolerance and hypertension. [ 12 ] Thyroiditis Aetiology Acute : usually [patient.info]

    Thyrotoxicosis • Beta blockers to decrease palpitations and reduce shakes and tremors may be helpful. 33. Hypothyroidism • thyroid hormone replacement. 34. [slideshare.net]

    CS Toe deformities Torticollis Tourette syndrome Toxoplasmosis Trace elements Transfusion Transient global amnesia Translation and protein synthesis Transplantation Trauma- and stressor-related disorders Traumatic brain injury Traumatic eye injuries Tremor [amboss.com]

  • Hyperactivity

    […] stomatitis Arm and elbow Arterial blood gas analysis and pulse oximetry Asbestosis Ascites Aspergillosis Asplenia Asthma Astrocytoma Atelectasis Atherosclerosis Atopic dermatitis Atrial fibrillation Atrioventricular block Atrophic gastritis Attention deficit hyperactivity [amboss.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.medscape.com]

Treatment

Treatment The treatment of acute thyroiditis is focused on eliminating the infection and reducing symptoms while the infection resolves. [verywell.com]

Our report indicates that tamoxifen can be a valuable drug therapy in the treatment of Riedel's thyroiditis. [ncbi.nlm.nih.gov]

Surgical Treatment for Riedel’s Thyroiditis: a Case Report © 2017 Korean Thyroid Association. [ijthyroid.org]

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]

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.medscape.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.medscape.com]

Epidemiology

[…] 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]

[…] 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]

EPIDEMIOLOGY Women are three to five times more likely to be affected than men. [aafp.org]

Hypothyroidism Epidemiology Hypothyroidism (including subclinical hypothyroidism) occurs in 2.5% of pregnant women. [patient.info]

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.medscape.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.com]

Surgery was performed to obtain a definitive diagnosis and prevent the possibility of subsequent additional tracheal compression with airway compromise. [jamanetwork.com]

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