Preview

Endocrine Surgery

Advanced search

Riedel's Thyroiditis. A Clinical Review.

Abstract

Riedel`s thyroiditis is a rare disease with an unknown etiology, which is characterized by replacement of the thyroid gland tissue with a fibrous connective tissue, the main characteristic sign is the stony-hard texture of the gland, extending to the surrounding structures (trachea, esophagus, blood vessels and nerves). Dense adhesion causes clinical symptoms of tracheal compression, such as shortness of breath, hoarseness, coughing and dyspnoea. Regarding functional activity, both euthyroidism and thyrotoxicosis with the subsequent development of hypothyroidism can be observed. A difficult preoperative diagnosis allows only to suspect this disease, as well as differentiate it with some aggressive forms of cancer, and therefore the final diagnosis is possible only after histological and immunohistochemical examinations of postoperative material. The conservative treatment (mainly glucocorticoid drugs) and surgical intervention can be applied. It is necessary to be meticulous about the choice of a treatment method, taking into account the firmly adhesion with surrounding structures and a high risk of complications of surgical treatment of the thyroid gland. This case report describes a patient with a confirmed morphological diagnosis of Riedel's thyroiditis after thyroidectomy. The peculiarity of this case is a clear positive correlation of the occurrence of subfebrile fever with the onset of the disease and its resolution after surgical treatment and a 11-month follow-up period.

About the Authors

Elena V. Pokrovskaya
Endocrinology Research Centre
Russian Federation

MD



Dmitriy G. Beltsevich
Endocrinology Research Center
Russian Federation

MD, ScD, Professor, leading research associate of the surgery department



Aleksandr Yu. Abrosimov
Endocrinology Research Centre
Russian Federation

MD, PhD, Professor



Sergey V. Lishchuk
A.I. Burnazyan Federal Medical Biophysical Center
Russian Federation

MD, PhD, Head of Department of Pathology



Valeriy V. Voskoboynikov
Endocrinology Research Centre
Russian Federation

MD, PhD



Anastassia Chevais
Endocrinology Research Centre, Moscow, Russia
Russian Federation

medical resident



References

1. Falhammar H, Juhlin CC, Barner C, et al. Riedel's thyroiditis: clinical presentation, treatment and outcomes. Endocrine. 2018;60(1):185-192. doi: https://doi.org/10.1007/S12020-018-1526-3.

2. Darouichi M, Constanthin PE. Riedel's thyroiditis. Radiol Case Rep. 2016;11(3):175-177. doi: https://doi.org/10.1016/j.radcr.2016.05.017.

3. Walsh J, Griffin TP, Ryan CB, et al. A case report demonstrating how the clinical presentation of the diffuse sclerosing variant of papillary thyroid carcinoma can mimic benign Riedel's thyroiditis. Case Rep Endocrinol. 2015;2015:686085. doi: https://doi.org/10.1155/2015/686085.

4. Shahi N, Abdelhamid MF, Jindall M, Awad RW. Riedel's thyroiditis masquerading as anaplastic thyroid carcinoma: a case report. J Med Case Rep. 2010;4:15. doi: https://doi.org/10.1186/1752-1947-4-15.

5. Wojciechowska-Durczyńska K, Durczyński A, Sporny S, et al. Riedel's thyroiditis – a case report with genes' expression studies. Thyroid Res. 2012;5(1):2. doi: https://doi.org/10.1186/1756-6614-5-2.

6. Василенко В.В., Виноградов Д.Л., Бурлакова А.С. IGG4-сопряженная патология: состояние проблемы // Архивъ внутренней медицины. – 2017. – T.7. – №2. – С. 95-106. [Vasilenko VV, Vinogradov DL, Burlakova AS. IGG4-related disease: condition of the problem. Archive of internal medicine. 2017;7(2):95-106. (In Russ.)] doi: https://doi.org/10.20514/2226-6704-2017-7-2-95-106.

7. Зубеев П.С., Коновалов В.А., Орлинская Н.Ю., и др. Дооперационная диагностика и лечение тиреоидита Риделя // Медицинский альманах. – 2011. – №5. – С. 138-140. [Zubeev PS, Konovalov VA, Orlinskaya NYu, et al. Presurgical diagnostics and treatment of Riedel thyroiditis. Meditsinskii almanakh. 2011;(5):138-140. (In Russ.)]

8. Hennessey JV. Riedel's thyroiditis: a clinical review. J Clin Endocrinol Metab. 2011;96(10):3031-3041. doi: https://doi.org/10.1210/Jc.2011-0617.


Supplementary files

1. Fig. 1. The appearance of the patient’s neck.
Subject
Type Other
View (50KB)    
Indexing metadata ▾
2. Fig. 2. MSCT of the chest in a longitudinal section.
Subject
Type Other
View (46KB)    
Indexing metadata ▾
3. Fig. 3. MSCT of the chest in cross section.
Subject
Type Other
View (37KB)    
Indexing metadata ▾
4. Fig. 4. Postoperative preparation of the thyroid gland.
Subject
Type Other
View (64KB)    
Indexing metadata ▾
5. Fig. 5. The histological picture of the postoperative material of the thyroid gland.
Subject
Type Other
View (113KB)    
Indexing metadata ▾
6. Таблица 1
Subject
Type Other
Download (11KB)    
Indexing metadata ▾
7. Таблица 1 исправленная
Subject
Type Other
Download (11KB)    
Indexing metadata ▾
8. Fig. 6. Obliterating phlebitis (stained with hematoxylin-eosin).
Subject
Type Other
View (169KB)    
Indexing metadata ▾
9. Fig. 7. IgG4 + plasma cells during the IHC study.
Subject
Type Other
View (143KB)    
Indexing metadata ▾

Review

For citations:


Pokrovskaya E.V., Beltsevich D.G., Abrosimov A.Yu., Lishchuk S.V., Voskoboynikov V.V., Chevais A. Riedel's Thyroiditis. A Clinical Review. Endocrine Surgery. 2019;13(3):133-140. (In Russ.)

Views: 19046


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2306-3513 (Print)
ISSN 2310-3965 (Online)