A patient with Riedel’s thyroiditis (chronic sclerosing thyroiditis) may present with a number of clinical findings.
Local complaints secondary to compression:
(1) dyspnea with or without a feeling of suffocation
(2) dysphagia
(3) hoarseness
(4) aphonia
(5) painless neck pressure
History:
(1) autoimmune disease
The physical exam shows a firm mass in the region of the thyroid gland that may be rock hard and which may not move freely during swallowing (anchored).
Laboratory findings:
(1) elevated erythrocyte sedimentation rate (ESR)
(2) serum antithyroid antibodies
Complications:
(1) hypothyroidism, less often hyperthyroidism
(2) hypoparathyroidism (with hypocalcemia)
(3) findings associated with IgG4 disease affecting other organs
(4) entrapment of the recurrent laryngeal or other nerves
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