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Case Report
Riedel’s thyroiditis as a part of the IgG4 systemic disease: A case report
1 Endocrine Division, Hospital Universitário Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro/RJ, Brazil
2 Postgraduate Program in Clinical and Experimental Pathophysiology (FISCLINEX), Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro/RJ, Brazil
3 Reumathology Division, Hospital Universitário Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro/RJ, Brazil
4 Pathology and Cytopathology Laboratory, Microimagem, Rio de Janeiro/RJ, Brazil
5 MD, PhD, Endocrine Division, Hospital Universitário Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro/RJ, Brazil
Address correspondence to:
Bárbara Gehrke
Boulevard 28 de Setembro, 77, Vila Isabel, Rio de Janeiro 20551-030,
Brazil
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Article ID: 101194Z01TM2021
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How to cite this article
Marques T, Gehrke B, Ribeiro FM, Machado M, Romano SO, Coelho MCA. Riedel’s thyroiditis as a part of the IgG4 systemic disease: A case report Int J Case Rep Images 2021;12:101194Z01TM2021.ABSTRACT
Introduction: Riedel’s thyroiditis (RT) is a fibro-inflammatory process that can affect the thyroid gland alone or might extend to adjacent tissues. This condition may evolve to multifocal systemic fibrosclerosis in 30–40% of the patients. Riedel’s thyroiditis is a rare disease that is usually treated by surgery as it consists of a hardened, adhered goiter with local invasion that resembles a malignant lesion. This thyroid disease is considered the most associated to immunoglobulin G4-related disease (IgG4-RD). IgG4-RD is characterized by a dense lymphoplasmacytic infiltrate with numerous IgG4 positive plasma cells present in other organs besides the thyroid.
Case Report: The report refers to a 53-year-old female Brazilian patient. The patient had a medical history of hypothyroidism and also showed increase of the cervical volume since the beginning of 2018. A surgical treatment was proposed in 2019 and histological aspects suggested the diagnosis of RT. After further analysis of the material obtained in biopsy, the microscopy assessment revealed lymphoplasmacytic inflammation with high fibrosis suggesting IgG4 related sclerotic disease.
Conclusion: This case highlights the importance of investigating IgG4-RD in patients with RT as it seems to be a new clinical entity. The diagnosis is a challenge and the combination of histopathological features/immunohistochemical staining with clinical, laboratorial, and radiological findings is extremely important.
Keywords: Immunoglobulin G4-related disease, Retroperitoneal fibrosis, Sclerosis, Thyroiditis
SUPPORTING INFORMATION
Author Contributions
Thamyres Marques - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Bárbara Gehrke - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Francinne Machado Ribeiro - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Marise Machado - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Sérgio de Oliveira Romano - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Maria Caroline Alves Coelho - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Thamyres Marques et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
