//fpnotebook.com/
Riedel's Thyroiditis
Aka: Riedel's Thyroiditis, Riedel Thyroiditis, Fibrous Thyroiditis
- See Also
- Thyroiditis
- Pathophysiology
- Idiopathic destructive Thyroiditis resulting in fibrosis of Thyroid and adjacent neck
- May be associated with more generalized fibrosis
- Idiopathic Multifocal Fibrosclerosis
- Epidemiology
- Onset age 30 to 60 years
- Symptoms
- Symptoms are related to local compression on esophagus and trachea (typically symptoms are more significant than the actual Goiter size)
- Compressive symptoms
- Stridor or Dyspnea
- Dysphagia
- Hoarseness
- Signs
- Very firm (rock or wood-like) Thyroid swelling (Goiter)
- Hypothyroidism (30%)
- Labs
- Thyroid Function Tests (T4 Free and TSH)
- Most patients are euthyroid (70%)
- Hypothyroidism (Increased Serum TSH and decreased T4 Free) in up to 30% of cases
- Antithyroid peroxidase antibodies (>60%)
- Serum Calcium
- Hypocalcemia occurs if fibrosis affects the adjacent Parathyroid Glands
- Imaging
- Radioiodine Uptake (Thyroid uptake and scan)
- Low uptake (contrast with Grave's Disease)
- Diagnosis
- Thyroid biopsy
- Management: Tracheal or esophageal compression
- First-line
- Surgical decompression
- Other agents (no definitive treatment)
- Corticosteroids
- Mycophenolate (Cellcept)
- Methotrexate
- Tamoxifen (suppresses fibroblast proliferation)
- References
- Bindra (2006) Am Fam Physician 73(10):1769-76 [PubMed]
- Quintero (2021) Am Fam Physician 104(6): 609-17 [PubMed]
- Sweeney (2014) Am Fam Physician 90(6): 389-96 [PubMed]