Riedel Thyroiditis

Abstract

Context Riedel’s thyroiditis (RT) is a rare inflammatory autoimmune disease that is often a clinically diagnostic dilemma due to its insidious presentation and non-specific symptoms. Objective The aim of the present systematic review and meta-analysis is to clarify the presentation, management and outcomes of RT. Study Selection A systematic search of PubMed/MEDLINE and Web of Science was conducted to identify relevant reports published up to September 2019. Data Extraction First author, country, patient sex, ethnicity, presentation, biochemical status, duration of symptoms, histology, treatment, follow-up duration, and short- and long-term outcomes. Data Synthesis Data from 212 RT patients was retrieved. The mean age was 47 years with a predominantly female population (81%). Neck swelling (89%), dyspnea (50%), neck pain (41%) were the most common presenting symptoms. Inflammatory markers were elevated in 70-97% and thyroid antibody positivity was present in less than 50%. Up to 82% underwent surgical intervention, with the most common being total thyroidectomy in 34% of individuals. Glucocorticoids were utilized in 70% of individuals with median duration 3 months. Prognosis was reasonable with 90% having resolution or improvement of symptoms. Conclusions This analysis is the largest and most comprehensive to date of RT and provides clinicians with vital information on the common presentation features that may alert to the diagnosis and to highlight management options.

Tracheoesophageal fistula caused by chemotherapy in primary thyroid lymphoma: a case report

“…Ultrasound is still the preferred imaging method due to its convenience and speed, but it lacks specificity for PTL, which has a very low echo and an unclear boundary. Further, PTL needs to be differentiated from Riedel's thyroiditis and anaplastic thyroid cancer (10,11). Neck enhanced CT is usually atypical.…”

A case of reversible hypoparathyroidism in a patient with Riedel's thyroiditis treated with glucocorticoids

“…In 46% of cases, hypothyroidism was present before the diagnosis of RT as in our patient. 1 Thyroid antibodies were positive in 50% of cases. 1 In our patient, thyroid antibodies were not available at the diagnosis of hypothyroidism and were negative at the diagnosis of RT.…”

“…The dose and duration of the therapy depend on the response and tolerance The average daily dose is 15-60 mg and the median duration of treatment is about 3 months in most cases. 1,3,16 In case of a lifethreatening dyspnea, prednisolone can be administered parenterally at the dose of 2-3 mg/kg/day for 2-7 days according to the clinical response. 16 Glucocorticoids are more effective if introduced early in the disease.…”

“…Riedel's thyroiditis (RT) is a rare benign fibroinflammatory thyroid disease. Its estimated incidence is suggested to be one case per 100,000 inhabitants 1 . The pathophysiological mechanisms of RT are still unclear.…”

IgG4 immunohistochemistry in Riedel's thyroiditis and the recommended criteria for diagnosis: A case series and literature review

“…It was first recognized in 1896 by Riedel as a hard, infiltrative lesion in the thyroid gland in two cases that were thought to be malignant but were histologically proven to be otherwise 3 . Histologically, RT manifests as a fibroinflammatory process with extension into surrounding tissues, including inflammatory cell infiltrates, destruction of the thyroid follicles and obliterative phlebitis 1,3–6 …”