Endocrinology Book

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Riedel's ThyroiditisAka: Fibrous Thyroiditis

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  1. Pathophysiology
    1. Idiopathic fibrosis of Thyroid and adjacent neck
    2. May be associated with mor generalized fibrosis
      1. Idiopathic Multifocal Fibrosclerosis
  2. Epidemiology
    1. Onset age 30 to 60 years
  3. Symptoms
    1. Symptoms related to compression on esophagus, trachea
      1. Stridor or Dyspnea
      2. Dysphagia
  4. Signs
    1. Very firm (rock or wood-like) Thyroid swelling
    2. Hypothyroidism (30%)
  5. Labs
    1. Thyroid Function Tests (T4 Free and TSH)
    2. Antithyroid peroxidase antibodies (>60%)
  6. Imaging
    1. Radioiodine Uptake (Thyroid uptake and scan)
      1. Low uptake (contrast with Grave's Disease)
  7. Diagnosis
    1. Open Thyroid biopsy
  8. Management: Tracheal or esophageal compression
    1. First-line
      1. Surgical decompression
    2. Other agents
      1. Corticosteroids
      2. Methotrexate
      3. Tamoxifen
  9. References
    1. Bindra (2006) Am Fam Physician 73(10):1769

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