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Riedel's thyroiditis association with IgG4-related disease.

Marius N Stan1, Vikram Sonawane1, Thomas J Sebo2

  • 1Department of Internal Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, MN, USA.

Clinical Endocrinology
|September 21, 2016
PubMed
Summary
This summary is machine-generated.

Riedel's thyroiditis (RT) is part of the IgG4-related disease (IgG4-RD) spectrum, though IgG4 staining did not differentiate it from Hashimoto's thyroiditis (HT). IgG4+ cell density in RT correlates inversely with disease duration.

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Area of Science:

  • Endocrinology
  • Immunology
  • Pathology

Background:

  • Immunoglobulin G4 (IgG4)-positive plasma cells are characteristic of IgG4-related disease (IgG4-RD).
  • These cells have been observed in both Riedel's thyroiditis (RT) and Hashimoto's thyroiditis (HT).

Purpose of the Study:

  • To investigate whether Riedel's thyroiditis is a manifestation within the IgG4-related disease spectrum.
  • To compare IgG4-positive plasma cell infiltration in RT versus Hashimoto's thyroiditis.

Main Methods:

  • A case-control study comparing 6 RT cases with 6 age- and gender-matched HT controls.
  • Analysis included IgG4 immunostaining of paraffin-embedded thyroid tissue.
  • Outcome measures focused on IgG4 staining intensity and clinical/histological correlates with IgG4-RD.

Main Results:

  • Positive IgG4 staining was present in 5/6 cases of both RT and HT.
  • While IgG4+ cell density was numerically higher in RT, no statistically significant difference was found compared to HT.
  • A significant inverse correlation was observed between IgG4+ cell count and disease duration in RT (P=0.046).
  • Three RT patients had comorbidities associated with IgG4-RD, unlike HT patients.

Conclusions:

  • Riedel's thyroiditis is identified as a component of the IgG4-related disease spectrum.
  • The density of IgG4-positive lymphocytic infiltrate in RT is time-dependent.
  • IgG4 staining intensity alone is not a reliable diagnostic differentiator between RT and HT in this study.