Riedel's thyroiditis: diagnosis, treatment and clinical recommendations

In the article, we consider the clinic, diagnosis and treatment of Riedel thyroiditis.

The endocrine system is a set of anatomical formations that are part of a group of small follicles that produce iodothyronines, which are hormones. At the moment, quite a lot of pathologies affecting the thyroid gland are described. One of them is thyroiditis, described by Riedel. This pathology occurs in 0.05% of all cases of identified diseases that make up the endocrine system. Riedel’s thyroiditis, described at the end of the 19th century, is a pathological process during which the connective tissue of the glands of the fibrous gland is replaced.

Description and reasons

The composition of fibrous tissue includes collagen fibers, which contributes to the formation of a dense structure and extracellular matrix. It is collagen that gives a certain form to internal organs. In addition, the substance is an important component of connective tissue, which is able to replace any others at the time of formation of scars and scars.

Thus, Riedel's thyroiditis is, in fact, a replacement for healthy thyroid tissue with fibrous fibers that do not produce iodothyronines and other hormones.

At the moment, there are no research results on the topic of prerequisites that precede the growth of fibrous tissue. In the community of medical professionals, there is no consensus on this. Nevertheless, the following clinical features that are characteristic for the progression of pathological processes in the endocrine system are distinguished:

1. A systemic disorder that can affect a patient of any gender and age.
2. Experts emphasize the lack of a genetic predisposition to the development of fibrotic thyroiditis.
3. The rapid course of pathology, at the initial stage of development having a latent form.
4. Lack of communication with Hashimoto's goiter, arising for autoimmune reasons.
5. The absence of antibodies to the thyroid gland cells in the blood.

The presence of a systemic disorder is confirmed by the identification of an identical proliferation of fibrous tissue in other endocrine organs, including in the pancreas. Riedel's thyroiditis is an inflammatory process in which both the entire thyroid gland and its individual follicles can be involved. Despite the fact that tissue replacement with fibrous thyroiditis provokes the appearance of inflammation, the functional component of the thyroid gland remains untouched.

Provocative factors

Many tend to believe that fibrotic thyroiditis can also occur under the influence of the following factors:

1. Transferred ARVI and ARI.
2. An excess of chloride, fluoride and iodide compounds in food and water used by humans.
3. Diseases of the nasopharynx of an infectious nature, proceeding in a chronic form.
4. State of stress.
5. Prolonged exposure to sunlight or radiation.
6. Self-medication using iodine-containing and hormonal drugs.

Today, there are no methods for the effective treatment of fibrotic thyroiditis. The main method of therapy is surgery.

Symptoms and course of the disease

At the initial stage of development of Riedel’s fibrous thyroiditis, no changes in the patient’s condition occur. However, the pathology is developing rapidly, and the first complaints may appear in a few weeks. The initial signs of the disease are:

1. Sensation of tightness of the skin in the front of the neck.
2. Bursting in the thyroid gland.
3. Female patients complain of limited mobility of the base of the tongue, in men there is a compaction of the Adam's apple with Riedel thyroiditis (pictured is a woman with this pathology).

When the connective tissue grows, the thyroid gland begins to compress adjacent organs. Against the background of a progressing pathology, the following signs are observed:

1. Change in timbre, hoarseness and reflex cough.
2. Shortness of breath, accompanied by shortness of breath.
3. Increased sensation of a lump in the throat.

At the first signs of thyroiditis, you should immediately contact a specialist and undergo an examination.

Complications and consequences

Despite preserving the functional component of the thyroid gland, Riedel’s fibrous thyroiditis causes the following dangerous complications:

1. With a significant growth of the neoplasm, it becomes difficult for the patient to breathe, talk and eat.
2. When the blood vessels of the circulatory system are squeezed, inflammation occurs in the tissues, which begin to experience a lack of oxygen.
3. The spread of fibrous tissue to adjacent organs.

Fibrous tissue is able to affect not only the thyroid gland, but also spread to a bundle of vessels and nerves in the neck, vocal cords, trachea, esophagus and any anatomical formations.

Diagnosis of Riedel thyroiditis

Identification of thyroiditis and classifying it as a fibrous type requires a comprehensive examination of the organs of the endocrine system, including instrumental and laboratory methods, as well as a detailed history.

Diagnosis of the disease at the initial stage of its development is not possible. Only with the onset of the first symptoms do patients turn to endocrinologists. The final diagnosis is based on the results of laboratory tests.

Having collected an anamnesis and examining the patient, the specialist prescribes the following studies:

1. A general blood type test.
2. The immunogram.
3. Ultrasound examination of the thyroid gland.
4. Fine needle biopsy of education for cytological examination.
5. Determination of the content of thyroid-stimulating hormone, which is in the blood serum.

Based on the data obtained during the examination, the endocrinologist confirms the presence of thyroiditis and determines its type. Then prescribes treatment, which depends on the individual characteristics of each patient.

Treatment

At the moment, medicine offers only a surgical method for the treatment of Riedel's thyroiditis. Modern methods of conservative treatment do not give a stable result, therefore, they are considered ineffective. Depending on the speed with which the disease progresses, they decide on the operation, the indications for which are:

1. Education has reached a size of more than 4 centimeters.
2. The trachea is compressed, which makes breathing difficult and complicates food intake.
3. There was a compression of the nerves, pain and discomfort were expressed.

There are several methods of surgical intervention:

1. Removal of the thyroid lobe.
2. Removing the entire gland completely.
3. Resection of the isthmus of the thyroid gland.

Hormone replacement therapy

With partial or complete removal of the gland, hormone replacement therapy is prescribed to the patient. With the right drugs and their dosage, the development of undesirable reactions to hormone intake is excluded. The widespread belief that patients on hormonal drugs gain weight, become aggressive or, conversely, drowsy, is nothing more than a delusion.

Prevention

As a prophylaxis of endocrine diseases, experts recommend regular ultrasound examination of the thyroid gland, as well as examination by a specialist. Successful treatment directly depends on the timeliness of a patient's visit to a specialist, so you should not delay it.

We reviewed the clinical guidelines for Riedel thyroiditis.