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Management of Riedel Thyroiditis With Completion Thyroidectomy to Relieve Persistent Compressive Symptoms
Alice S Win1, Katarina A Topchyan1, Philip W Smith1
1University of Virginia School of Medicine, Charlottesville, VA 22903, USA.
JCEM Case Reports
|August 1, 2025
Summary
Riedel thyroiditis, a rare IgG4-related condition, often requires surgery when medical treatments fail. Complete thyroidectomy can relieve airway obstruction but may lead to hypoparathyroidism.
Area of Science:
- Endocrinology
- Immunology
- Surgical Pathology
Background:
- Riedel thyroiditis is a rare IgG4-related condition causing thyroid fibrosis and inflammation.
- Medical management is the first-line treatment, but surgical intervention is sometimes necessary.
Observation:
- A 40-year-old patient with Riedel thyroiditis experienced compressive symptoms unresponsive to prednisone, tamoxifen, and mycophenolate mofetil.
- Initial right thyroid lobectomy provided incomplete symptom relief.
Findings:
- Completion thyroidectomy significantly improved airway obstruction but resulted in chronic hypoparathyroidism.
- Serial imaging and pulmonary function tests are valuable for assessing tracheal stenosis severity.
Implications:
- Complete thyroid resection may be a feasible option for Riedel thyroiditis with airway obstruction.
- This case underscores the importance of multidisciplinary evaluation for managing complex Riedel thyroiditis cases.
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