Riedel Thyroiditis

Author: Chris K Guerin, MD, FACE; Chief Editor: George T Griffing, MD more...
Overview
Presentation
DDx
Workup
Treatment
Medication
Updated: Apr 25, 2014

Background

Etiology
Epidemiology
Prognosis
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References

Prognosis
Riedel thyroiditis (RT) is generally a self-limited disease with a favorable prognosis. Death due to
airway compromise is very rare in treated patients. Occasionally, spontaneous remission has been
reported. Patients can also relapse.
In RT, morbidity is most frequently related to local compressive symptoms, such as dysphagia,
dyspnea, hoarseness, and cough. Hypothyroidism is present in 30% of cases. Fibrotic invasion of
adjacent anatomic structures may infrequently result in symptoms related to recurrent laryngeal nerve
paralysis or hypoparathyroidism.
One third of patients with RT ultimately develop at least 1 extracervical manifestation of multifocal
fibrosclerosis (such as retroperitoneal fibrosis, mediastinal fibrosis, or sclerosing cholangitis). [7] In such
patients, the prognosis essentially becomes that of extracervical fibrosclerosis. Therefore, when RT is
diagnosed, it is essential to perform abdominal and chest imaging studies to exclude concomitant,
extracervical entities from multifocal fibrosclerosis. Fibrosclerosis of the surrounding tissue by RT can
lead to serious morbidity and death.
A retrospective institutional review of a rare form of invasive thyroiditis from the Mayo Clinic discussed
the common presenting symptoms and extrathyroidal involvement of the systemic fibrosclerosis.
Treatments used in the 21 reported patients included partial thyroidectomy, tamoxifen, and
corticosteroid therapy. Other, less well validated studies include mycophenolate mofetil [8] and
rituximab.[9] Of note, no cause-specific mortality was noted, and the fibrotic process stabilized or
partially resolved in all patients.[3]