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 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)

Testing

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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References:

1. Riedel Thyroiditis
   http://emedicine.medscape.com/article/125243-overview
2. Acute and Subacute , and Riedel’s Thyroiditis
   thyroidmanager.org/chapter/acute-and-subacute-and-riedels-thyroiditis/
3. Riedel’s Thyroiditis: A Clinical Review
   https://doi.org/10.1210/jc.2011-0617
4. Overview of Riedel’s Thyroiditis: Fibrous Thyroiditis/Invasive Thyroiditis
   http://thyroid.about.com/od/thyroidbasicsthyroid101/a/riedels-invasive-thyroiditis.htm
   
   Date updated: 09/05/2021 (V1.2)
   Review date: 07/12/21