TRANSLATIONAL AND CLINICAL MEDICINE - Georgian Medical Journal

Background: The coexistence of Riedel's thyroiditis and Graves' disease is quite rare, presents a diagnostic dilemma and requires a particular clinical approach.

Case report: We describe a 69-year-old man who had two autoimmune processes - Riedel's thyroiditis and Graves' disease, which develop at the same time in different lobes of the thyroid with contradictory manifestations. The diagnosis was confirmed by histological examination.

Conclusions: Present case is unique by development and management, especially, it should be noted that iodine deficient thyroid diseases are endemic to the Caucasus region (Georgia), although the present case is the only one in our observation period (2016-2019).

Riedel B.M. Die chronische, zur Bildung eisenharter Tumoren führende Entzündung der Schilddrüse. Verh. Dtsch. Ges. Chir. 1896; 25: 101–105.

Schwaegerle SM, Bauer TW, Esselstyn CB Jr. Riedel's thyroiditis. Am J Clin Pathol. 1988; 90(6):715-22.

Guerin CK. Riedel Thyroiditis. Medscape. 2017.

Gvianishvili T, Gogiashvili L, Chkhobadze M. Molecular-biological thyroid profile during autoimmune disease - Hashimoto and Riedel’s Thyroiditis. Georgian Medical News №5 (290), 2019, ISSN 1512-0112

Rurua N, Gogiashvili L, Tsagareli Z. Immunohistochemical Investigation of Angiogenesis Activity in Thyroid Gland under Hashimotos Thyroiditis versus Diffuse Toxic Goiter. Journal of Basic & Clinical Medicine 2015, 4(1):32-36

Lee DY, Moon JS, Kim GE, Kim HK, Kang HC. Riedel Thyroiditis in a Patient with Graves Disease. Endocrinol Metab. 2013; 28(2): 138–143. doi: 10.3803/EnM.2013.28.2.138.

McIver B, Fatourechi MM, Hay ID, Fatourechi V. Graves disease after unilateral Riedel’s thyroiditis. J Clin Endocrinol Metab 2010;95:2525-6.

Pi GY, Lee YS, Hong SW, Chang HS, Park CS. A case of Riedel’s thyroiditis. J Korean Surg Soc 2012;82:317-20.

Katabathina VS, Khalil S, Shin S, Lath N, Menias CO, Prasad SR. Immunoglobulin G4-Related Disease: Recent Advances in Pathogenesis and Imaging Findings. Radiol Clin North Am. 2016; 54 (3):535-51.

Li Y, Zhou G, Ozaki T, Nishihara E, Matsuzuka F, Bai Y, et al. Distinct histopathological features of Hashimoto’s thyroiditis with respect to IgG4-related disease. Mod Pathol. 2012; 25:1086-97.

Dahlgren M, Khosroshahi A, Nielsen GP, Deshpande V, Stone JH. Riedel's thyroiditis and multifocal fibrosclerosis are part of the IgG4-related systemic disease spectrum. Arthritis Care Res (Hoboken). 2010; 62(9):1312-8.

Takeshima K, Inaba H, Ariyasu H, Furukawa Y, Doi A, Nishi M, et al. Clinicopathological features of Riedel's thyroiditis associated with IgG4-related disease in Japan. Endocrine Journal. 2015; 62(8):725-31. doi: 10.1507/endocrj.EJ15-0175.

Pusztaszeri M, Triponez F, Pache JC, Bongiovanni M. Riedel's thyroiditis with increased IgG4 plasma cells: evidence for an underlying IgG4-related sclerosing disease? Thyroid. 2012; 22(9):964-8.

Blanco VM, Páez CA, Victoria AM, Arango LG, Arrunategui AM, Escobar J, et al. Riedel’s Thyroiditis: Report of Two Cases and Literature Review. Case Reports in Endocrinology 2019:5130106. doi: 10.1155/2019/5130106

Wu SY, Leung AM, Chambers MD, Chen CL, Khan MU, Brent GA, et al. Coexistent presentation of Graves' disease and an autonomous thyroid nodule following administration of an iodinated contrast load. Journal of Clinical and Translational Endocrinology: Case Reports 2018. https://doi.org/10.1016/j.jecr.2018.05.001