Endocrinology and Metabolism

Original Article

Thyroid
Immunoglobulin G4-Related Thyroid Disease: A Single-Center Experience and Literature Review: Meihua Jin, Bictdeun Kim, Ahreum Jang, Min Ji Jeon, Young Jun Choi, Yu-Mi Lee, Dong Eun Song, Won Gu Kim; Endocrinol Metab. 2022;37(2):312-322. Published online April 25, 2022; DOI: https://doi.org/10.3803/EnM.2021.1318

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Background
Immunoglobulin G4 (IgG4)-related disease is an entity that can involve the thyroid gland. The spectrum of IgG4-related thyroid disease (IgG4-RTD) includes Hashimoto thyroiditis (HT) and its fibrotic variant, Riedel thyroiditis, as well as Graves’ disease. The early diagnosis of IgG4-RTD is important because it is a medically treatable disease, and a delay in the diagnosis might result in unnecessary surgery. We present a case series of IgG4-RTD with a review of the literature.
Methods
We retrospectively reviewed the clinical presentation and the radiological and pathological findings of patients diagnosed with IgG4-RTD between 2017 and 2021 at a tertiary medical center in Korea. We also conducted a literature review of IgG4-RTD.
Results
Five patients were diagnosed with IgG4-RTD during the study period. The patients’ age ranged from 31 to 76 years, and three patients were men. Most patients visited the clinic for a neck mass, and hypoechogenic nodular lesions were observed on neck ultrasonography. Three patients had IgG4 HT, and two patients had IgG4 Riedel thyroiditis. All patients developed hypothyroidism that necessitated L-thyroxine replacement. The diagnosis of IgG4-RTD was confirmed after a pathological examination of the surgical specimen in the first two cases. However, the early diagnosis was possible after a core needle biopsy in three clinically suspected patients.
Conclusion
The diagnosis of IgG4-RTD requires clinical suspicion combined with serology and histological analyses using IgG4 immunostaining. The early diagnosis of IgG4-RTD is difficult; thus, biopsy with IgG4 immunostaining and serum IgG4 measurements will help diagnose patients suspected of having IgG4-RTD.

Citations

Citations to this article as recorded by

Are sonographic characteristics of Hashimoto’s thyroiditis related with immunologic parameters? A cross-sectional study
K. Kenarlı, A. B. Bahçecioğlu, Ö. B. Aksu, S. Güllü
Journal of Endocrinological Investigation.2024;[Epub] CrossRef
Reshaping the Concept of Riedel’s Thyroiditis into the Larger Frame of IgG4-Related Disease (Spectrum of IgG4-Related Thyroid Disease)
Mara Carsote, Claudiu Nistor
Biomedicines.2023; 11(6): 1691. CrossRef

Case Report

Thyroid
Riedel Thyroiditis in a Patient with Graves Disease: Doo Young Lee, Jung Sik Moon, Ga-Eon Kim, Hee Kyung Kim, Ho-Cheol Kang; Endocrinol Metab. 2013;28(2):138-143. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.138

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36 Download
4 Web of Science
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Abstract PDF PubReader

Riedel's thyroiditis is a rare form of infiltrative and inflammatory disease of the thyroid gland and can be associated with systemic fibrotic processes, Hashimoto thyroiditis and Graves disease. Riedel thyroiditis in combination with Graves disease however, is very rare. A 57-year-old woman with a past medical history significant for Graves disease diagnosed 30 years ago presented with an enlarging neck mass and voice changes. Due to suspicion of malignancy, thyroidectomy was performed. Histopathologic examination revealed Riedel thyroiditis. To our knowledge, the association of Riedel thyroiditis with Graves disease has not yet been reported in our country. Here we report a patient with Riedel thyroiditis evolved from antecedent Graves disease.

Citations

Citations to this article as recorded by

IgG4-related sclerosing thyroiditis (Riedel-Struma): a review of clinicopathological features and management
Agata Czarnywojtek, Krzysztof Pietrończyk, Lester D. R. Thompson, Asterios Triantafyllou, Ewa Florek, Nadia Sawicka-Gutaj, Marek Ruchała, Maria Teresa Płazinska, Iain J. Nixon, Ashok R. Shaha, Mark Zafereo, Gregory William Randolph, Peter Angelos, Abir Al
Virchows Archiv.2023; 483(2): 133. CrossRef
Immunoglobulin G4-Related Thyroid Disease: A Single-Center Experience and Literature Review
Meihua Jin, Bictdeun Kim, Ahreum Jang, Min Ji Jeon, Young Jun Choi, Yu-Mi Lee, Dong Eun Song, Won Gu Kim
Endocrinology and Metabolism.2022; 37(2): 312. CrossRef
Riedel Thyroiditis
Aakansha Zala, Thomas Berhane, C Christofer Juhlin, Jan Calissendorff, Henrik Falhammar
The Journal of Clinical Endocrinology & Metabolism.2020; 105(9): e3469. CrossRef
Brief Review of Articles in 'Endocrinology and Metabolism' in 2013
Won-Young Lee
Endocrinology and Metabolism.2014; 29(3): 251. CrossRef

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