Riedel’s Thyroiditis


Riedel’s Thyroiditis


What is Riedel’s thyroiditis?

Riedel’s thyroiditis was recognised by Professor Bernhard Riedel back in 1883. It is a chronic and rare form of thyroiditis, sometimes referred to as Riedel’s struma.

Riedel’s thyroiditis is caused by a dense fibrosis that replaces normal thyroid tissue. The fibrotic process can spread and affect areas surrounding the thyroid gland itself. The level of symptoms and complications depend on the extent to which the thyroid gland and surrounding areas have been replaced with fibrotic tissue.

There is some evidence that Riedel’s thyroiditis could be a manifestation of an IgG4-related systematic disease, which affects multiple parts of the body including the pancreas, liver, kidney, salivary and orbital tissues as well as the retroperitoneum.


What are the symptoms?

The spreading of the fibrous tissues causes the thyroid and surrounding neck area to become hard.  Symptoms can include:

  • airway obstruction
  • hoarseness and in severe cases dysphonia (if the larynx/voice box is affected)
  • dysphagia (difficulty swallowing)
  • hypothyroidism
  • hypoparathyroidism
  • stridor (a high-pitched breath sound)



To establish an accurate diagnosis, your doctor or consultant will need to perform certain tests. Blood tests may be required to identify thyroid hormone imbalances or elevated antibodies and an ultrasound scan may also need to be performed to view the thyroid and surrounding area. A fine needle aspiration biopsy is often used to confirm the diagnosis of Riedel’s thyroiditis.


Which treatment options are available?

When treating Riedel’s thyroiditis, surgery may be required, depending on the level of obstruction caused by the fibrous tissue.

Other treatment options may include corticosteroids medicines such as levothyroxine, tamoxifen and prednisone.

Your doctor or consultant will be able to provide you with more information regarding your individual treatment needs.


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Corticosteroids – also known as steroids – anti-inflammatory medicine prescribed for a wide range of conditions

Dysphagia – the medical term for swallowing difficulties

Dysphonia – difficulty in speaking due to a physical disorder of the mouth, tongue, throat or vocal cords

Fibrosis – the formation of excess fibrous connective tissue in an organ or tissue in a reparative or reactive process

Hypothyroidism – a term used to describe an under-active thyroid gland

Hypoparathyroidism – a disorder caused by the parathyroid glands in the neck producing too little (hypo) parathyroid hormone

IgG4-Related Systematic Disease – immunoglobulin G4 is a chronic inflammatory condition characterised by tissue infiltration with lymphocytes and IgG4-secreting plasma cells, various degrees of fibrosis (scarring) and a usually prompt response to oral steroids

Kidney – a pair of organs in the abdominal cavity that excrete urine

Levothyroxine – a synthetic thyroid hormone commonly given to treat an underactive thyroid. It is also known as L-thyroxine

Liver – a large lobed glandular organ in the abdomen, involved in many metabolic processes

Orbital Tissues – the soft tissues surrounding the orbit (the cavity or socket of the eye)

Pancreas – a large gland behind the stomach, which secretes digestive enzymes into the duodenum

Prednisone – a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug and often used to treat certain inflammatory diseases

Retroperitoneum – the anatomical space in the abdominal cavity behind the peritoneum (membrane lining the cavity of the abdomen and covering the abdominal organs)

Salivary – any of the organs that secrete saliva

Stridor a high-pitched breath sound resulting from turbulent air flow in the larynx or lower in the bronchial tree

Tamoxifen – a drug that blocks the actions of oestrogen and is used to treat and prevent some types of breast cancer

Thyroid – a small butterfly shaped gland with two lobes situated in the front of your neck. The thyroid gland is one of the glands of the endocrine system.  It has two main functions – the control of metabolism – the rate at which all the chemistry of the body works – and the control of growth in early life

Thyroiditis – a swelling or inflammation of the thyroid gland causing unusually high or low levels of thyroid hormones in the blood stream



  1. Riedel Thyroiditis
  2. Acute and Subacute, and Riedel’s Thyroiditis
  3. Riedel’s Thyroiditis: A Clinical Review
  4. Overview of Riedel’s Thyroiditis: Fibrous Thyroiditis/Invasive Thyroiditis


Date updated: 21/02/20 (V1.1)
Review date: 07/12/20