Introduction
Riedel’s thyroiditis is a chronic inflammatory disease associated with fibrosis or woody enlargement of all or part of the thyroid gland
-it is now considered a IgG4-related systemic disease
-Women in midlife are most often affected
Symptoms & Signs
-Symptoms of hypothyroidism when enough thyroid tissue is replaced by fibrous tissue; compressive symptoms of the esophagus, trachea such as dysphagia, dyspnea, hoarseness; a hard, ‘woody’ thyroid gland
Diagnosis
Gross exam: hard, fixed, ‘woody’ thyroid gland
Labs: normal or low thyroid hormones, normal or elevated TSH, normal or elevated IgG4 levels
Open thyroid biopsy: a dense lymphoplasmacytic infiltrate rich in IgG4 plasma cells, storiform fibrosis, and obliterative phlebitis
Treatment
Surgery: decompression through thyroidectomy Hypothyroidism: thyroid hormone replacement