Riedel's thyroiditis differential diagnosis

Riedel's thyroiditis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Riedel's thyroiditis from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Riedel's thyroiditis differential diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Riedel's thyroiditis differential diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Riedel's thyroiditis differential diagnosis
CDC on Riedel's thyroiditis differential diagnosis
Riedel's thyroiditis differential diagnosis in the news
Blogs on Riedel's thyroiditis differential diagnosis
Directions to Hospitals Treating Psoriasis
Risk calculators and risk factors for Riedel's thyroiditis differential diagnosis

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

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

Conditions	Causes	Age at onset	Pathological findings	Diagnostic approach
Riedel's thyroiditis	Unknown	30-60	Dense fibrosis	Normal TSH (euthyroidism) TPO antibodies usually present I-123 uptake decreased or normal
Hashimoto's thyroiditis	Autoimmune	All ages, peak at 30-50	Lymphocytic infiltration Germinal centers Fibrosis (in some variants)	Increased TSH (hypothyroidism) TPO antibodies present in high titer I-123 uptake usually decreased
Painful subacute (De Quervain's) thyroiditis	Unknown	20-60	Giant cells Granulomas	Increased TSH (hypothyroidism) and/or Decreased TSH (Thyrotoxicosis) TPO antibodies absent or very low titer I-123 uptake decreased
Suppurative thyroiditis	Infection	Children, 20-40	Abscess formation	Normal TSH (euthyroidism) TPO antibodies absent I-123 uptake normal

Riedel's thyroiditis must be differentiated from other causes of hypothyroidism on the basis of history and symptoms and laboratory findings:

Disease		History and symptoms			Laboratory findings						Additional findings
		Fever	Pain	TSH	Free T4	T3	T3RU*	Thyroglobulin	TRH	TPOAb^
Primary hypothyroidism	Riedel's thyroiditis	-	-	N/↑	N/↓	N/↓	N/↓	N	N	Usually present	Riedel's thyroiditis usually presents with hard and fixed thyroid mass.
	Autoimmune (Hashimoto's thyroiditis)	-	-	↑	↓	N/↓	N/↓	N/↑	N	Present (high titer)	May be accompanied by other autoimmune diseases
	Infectious thyroiditis	+	+	N	N	N	N	N	N	Absent	Infectious thyroiditis associated with neck pain
Transient hypothyroidism	Subacute (de Quervain's) thyroiditis	+/-	+/-	↑/↓	↓/↑	N	↓	N	N	Absent	May present primarily with hyperthyroidism
	Post-partum thyroiditis	+/-	+/-	↑/↓	↓/↑	N	↓	N	N	Absent	May present primarily with hyperthyroidism
Others	Drug-induced	-	-	↑/↓	↓/↑	N	↓	N/↑	N	Absent**	History of hyperthyroidism Drug history
	Radiation-induced
	Trauma induced
	Radioiodine induced
	Thyroidectomy
	Subclinical hypothyroidism	-	-	↑	N	N	N	N	N	N/↑	Asymptomatic

• (*)T3RU; Triiodothyronine Resin uptake.
• (^)TPOAb; Thyroid peroxidase antibodies.
• (**)May be present in drug-induced hypo/hyperthyroidism such as Interferon-alpha, interleukin-2, and lithium.