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Riedel's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:<ref name="pmid16734054">{{cite journal |vauthors=Bindra A, Braunstein GD |title=Thyroiditis |journal=Am Fam Physician |volume=73 |issue=10 |pages=1769–76 |year=2006 |pmid=16734054 |doi= |url=}}</ref><ref name="pmid19949140">{{cite journal |vauthors=McDermott MT |title=In the clinic. Hypothyroidism |journal=Ann. Intern. Med. |volume=151 |issue=11 |pages=ITC61 |year=2009 |pmid=19949140 |doi=10.7326/0003-4819-151-11-200912010-01006 |url=}}</ref><ref name="urlThyroiditis — NEJM">{{cite web |url=http://www.nejm.org/doi/full/10.1056/NEJMra021194 |title=Thyroiditis — NEJM |format= |work= |accessdate=}}</ref><ref name="pmid18177256">{{cite journal |vauthors=Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR |title=Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002) |journal=Thyroid |volume=17 |issue=12 |pages=1211–23 |year=2007 |pmid=18177256 |doi=10.1089/thy.2006.0235 |url=}}</ref><ref name="pmid18415684">{{cite journal |vauthors=Lania A, Persani L, Beck-Peccoz P |title=Central hypothyroidism |journal=Pituitary |volume=11 |issue=2 |pages=181–6 |year=2008 |pmid=18415684 |doi=10.1007/s11102-008-0122-6 |url=}}</ref>
{| class="wikitable" align="center" style="border: 0px; margin: 3px;"
! colspan="2" rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Disease
! colspan="3" align="center" style="background: #4479BA; color: #FFFFFF; " |History and symptoms
! colspan="6" align="center" style="background: #4479BA; color: #FFFFFF; " |Laboratory findings
! rowspan="2" align="center" style="background: #4479BA; color: #FFFFFF; " |Additional findings
|-
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Fever 
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Pain
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TSH
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Free T4
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> T3RU
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> Thyroglobin
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TRH
! align="center" style="background: #4479BA; color: #FFFFFF; " |<small> TPOAb
|-
| rowspan="3" style="background:#DCDCDC;" |[[Primary hypothyroidism]]
| align="center" style="background:#DCDCDC;" |[[Riedel's thyroiditis]]
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↑
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Usually present
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
*[[Riedel's thyroiditis]] usually presents with hard and fixed thyroid mass.
|-
| align="center" style="background:#DCDCDC;" |[[Hashimoto's thyroiditis|Autoimmune]] ([[Hashimoto's thyroiditis]])
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''''↓'''''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Present (high titer)
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* May be accompanied by other [[autoimmune diseases]]
|-
| align="center" style="background:#DCDCDC;" |[[Infectious thyroiditis]]
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
*[[Thyroiditis|Infectious thyroiditis]] associated with [[neck pain]]
|-
| rowspan="2" style="background:#DCDCDC;" |[[Hypothyroidism|Transient hypothyroidism]]
| align="center" style="background:#DCDCDC;" |[[De Quervain's thyroiditis|Subacute (de Quervain's) thyroiditis]]
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* May present primarily with [[hyperthyroidism]]
|-
| align="center" style="background:#DCDCDC;" |Post-partum thyroiditis
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | +/-
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑/'''↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓/'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* May present primarily with [[hyperthyroidism]]
|-
| rowspan="8" style="background:#DCDCDC;" |Others
| align="center" style="background:#DCDCDC;" |Drug-induced
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''/↓
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''''↓'''''/↑
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |↓
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''↑'''
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| rowspan="5" align="center" style="padding: 5px 5px; background: #F5F5F5;" |Absent*
| rowspan="5" align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* History of [[hyperthyroidism]]
* Drug history
|-
| align="center" style="background:#DCDCDC;" |Radiation-induced
|-
| align="center" style="background:#DCDCDC;" |Trauma induced
|-
| align="center" style="background:#DCDCDC;" |Radioiodine induced
|-
| align="center" style="background:#DCDCDC;" |Thyroidectomy
|-
| align="center" style="background:#DCDCDC;" |Subclinical hypothyroidism
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" | -
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |'''↑'''
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N
| align="center" style="padding: 5px 5px; background: #F5F5F5;" |N/'''↑'''
| align="left" style="padding: 5px 5px; background: #F5F5F5;" |
* Asymptomatic
|-
|}
==References==
==References==


Revision as of 18:23, 5 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]

Overview

Riedel's thyroiditis must be differentiated from other causes of thyroiditis, such as De Quervain's thyroiditis, Hashimoto's thyroiditis, and suppurative thyroiditis.

Differentiating Hashimoto's Thyroiditis from other Diseases


Conditions Causes Age at onset Pathological findings Diagnostic approach
Riedel's thyroiditis
  • Unknown
  • 30-60
Hashimoto's thyroiditis
  • Autoimmune
  • All ages, peak at 30-50
Painful subacute (De Quervain's) thyroiditis
  • Unknown
  • 20-60
Suppurative thyroiditis
  • Infection
  • Children, 20-40


Riedel's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:[2][3][1][4][5]

Disease History and symptoms Laboratory findings Additional findings
Fever Pain TSH Free T4 T3 T3RU Thyroglobin TRH TPOAb
Primary hypothyroidism Riedel's thyroiditis - - N/↑ N/↓ N/↓ N/↓ N N Usually present
Autoimmune (Hashimoto's thyroiditis) - - ↑ ↓ N/↓ N/↓ N/↑ N Present (high titer)
Infectious thyroiditis + + N N N N N N Absent
Transient hypothyroidism Subacute (de Quervain's) thyroiditis +/- +/- ↑/↓ ↓/↑ N ↓ N N Absent
Post-partum thyroiditis +/- +/- ↑/↓ ↓/↑ N ↓ N N Absent
Others Drug-induced - - ↑/↓ ↓/↑ N ↓ N/↑ N Absent*
Radiation-induced
Trauma induced
Radioiodine induced
Thyroidectomy
Subclinical hypothyroidism - - ↑ N N N N N N/↑
  • Asymptomatic

References

  1. ↑ 1.0 1.1 "Thyroiditis — NEJM".
  2. ↑ Bindra A, Braunstein GD (2006). "Thyroiditis". Am Fam Physician. 73 (10): 1769–76. PMID 16734054.
  3. ↑ McDermott MT (2009). "In the clinic. Hypothyroidism". Ann. Intern. Med. 151 (11): ITC61. doi:10.7326/0003-4819-151-11-200912010-01006. PMID 19949140.
  4. ↑ Aoki Y, Belin RM, Clickner R, Jeffries R, Phillips L, Mahaffey KR (2007). "Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002)". Thyroid. 17 (12): 1211–23. doi:10.1089/thy.2006.0235. PMID 18177256.
  5. ↑ Lania A, Persani L, Beck-Peccoz P (2008). "Central hypothyroidism". Pituitary. 11 (2): 181–6. doi:10.1007/s11102-008-0122-6. PMID 18415684.

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