Эндокринная хирургия (Jan 2020)
Riedel's Thyroiditis. A Clinical Review.
Abstract
Riedel`s thyroiditis is a rare disease with an unknown etiology, which is characterized by replacement of the thyroid gland tissue with a fibrous connective tissue, the main characteristic sign is the stony-hard texture of the gland, extending to the surrounding structures (trachea, esophagus, blood vessels and nerves). Dense adhesion causes clinical symptoms of tracheal compression, such as shortness of breath, hoarseness, coughing and dyspnoea. Regarding functional activity, both euthyroidism and thyrotoxicosis with the subsequent development of hypothyroidism can be observed. A difficult preoperative diagnosis allows only to suspect this disease, as well as differentiate it with some aggressive forms of cancer, and therefore the final diagnosis is possible only after histological and immunohistochemical examinations of postoperative material. The conservative treatment (mainly glucocorticoid drugs) and surgical intervention can be applied. It is necessary to be meticulous about the choice of a treatment method, taking into account the firmly adhesion with surrounding structures and a high risk of complications of surgical treatment of the thyroid gland. This case report describes a patient with a confirmed morphological diagnosis of Riedelapos;s thyroiditis after thyroidectomy. The peculiarity of this case is a clear positive correlation of the occurrence of subfebrile fever with the onset of the disease and its resolution after surgical treatment and a 11-month follow-up period.
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