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Riedel's thyroiditis as a diagnostic dilemma - A case report and review of the literature.

ABSTRACT: Riedel's thyroiditis is a rare inflammatory process which not only involves thyroid gland but also the surrounding vital structures. It may also be associated with various forms of systemic fibrotic disorders. The exact etiology is not known, but currently, the most favored view is that of a localized form of the systemic fibrotic process. We report a case of Riedel's thyroiditis in a male patient, highlighting diagnostic challenges and a rare presentation of hypocalcemia and mimicking thyroid lymphoma. Clinical knowledge of such a presentation of Riedel's thyroiditis would enhance our ability to make a speedy diagnosis. Apart from avoiding aggressive surgical intervention, awareness of such a clinical entity may avoid complications and hence morbidity. Our case also highlights the difficulty in histological diagnosis which is vital to rule out malignancy and avoiding any major surgical intervention fraught with complications. Although the patient had a poor tolerance to Tamoxifen and Rituximab, however, his response to high dose steroids is the currently accepted treatment of choice. This case adds to the sparse literature available on the cytological diagnosis of RT and highlights the diagnostic challenge due to suspicious radiology findings.

SUBMITTER: Shafi AA

PROVIDER: S-EPMC7049561 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Riedel's thyroiditis as a diagnostic dilemma - A case report and review of the literature.

Shafi Alam Ara AA Saad Nourah Bin NB AlHarthi Bandar B

Annals of medicine and surgery (2012) 20200225

Riedel's thyroiditis is a rare inflammatory process which not only involves thyroid gland but also the surrounding vital structures. It may also be associated with various forms of systemic fibrotic disorders. The exact etiology is not known, but currently, the most favored view is that of a localized form of the systemic fibrotic process. We report a case of Riedel's thyroiditis in a male patient, highlighting diagnostic challenges and a rare presentation of hypocalcemia and mimicking thyroid l ...[more]

PMID: 32140224

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Project description:Background:We performed a review of published case studies of osteomyelitis associated with cat-scratch disease to consolidate existing information on clinical presentation, diagnostic tools, therapy, and outcome, as well as presenting a case of disseminated cat-scratch disease in a 12-year-old female with skull osteomyelitis and spleen involvement. Methods:A search for articles indexed in PubMed, Embase, and Google Scholar was performed with the search terms "Bartonella," "bone," "osteomyelitis," "osteolytic," and "cat-scratch disease" limited to the immunocompetent pediatric population and articles in English. Results:51 cases were identified. The average age was 7.8 years with equal sex distribution. Fever (84.3%), often with a prolonged course (64.7%), and osteoarticular pain (88.2%) were the most common clinical findings. Lymphadenopathy was present in 64.7% of patients. Vertebral body was mainly involved (51.9%). MRI (50%) and bone scintigraphy (48.1%) were favored to confirm osteomyelitis, while serology was the preferred microbiological diagnostic. Various antibiotics were prescribed in combined or sequential regimens, with median duration of therapy of 23 days. About 12.5% of patients did not receive any treatment. Most patients had excellent prognosis; in particular, all patients not receiving any therapy showed complete recovery and no recurrence of symptoms. Conclusions:Bartonella henselae should be considered in differential diagnosis of localized lymphadentitis. Osteoarticular pain or limitation during cat-scratch disease in children should always be investigated for bone spreading. Owing to good prognosis, invasive procedures to obtain the bone material should be avoided. Serology is the gold standard diagnostic tool and MRI is the best radiographic technique to define bone and surrounding tissue involvement. Treatment represents a never-ending dilemma: surgical intervention or use of antibiotics is still controversial, and more studies are needed to define the best antimicrobial regimen.

Dataset Information

Riedel's thyroiditis as a diagnostic dilemma - A case report and review of the literature.

Publications

Riedel's thyroiditis as a diagnostic dilemma - A case report and review of the literature.

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