Table 1.
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Meta-analysis of 212 individuals with Riedel thyroiditis

VariableCasesTotal No. of cases with information
SexMale n = 41 (19.3%)
Female n = 171 (80.7%)		212
Age, y47 (10.5-81) 212
Ethnicity Caucasian n = 55 (56%)
Asian n = 32 (33%)
African n = 5 (5%)
Black n = 2 (2%)
Arab n = 2 (2%)
Persian n = 2 (2%)		98
Smoking status Smokers n = 14 (16%)89
Comorbidities None n = 79 (80%)
•Asthma n = 3 (3%)
•Diabetes n = 7 (7%)
•Cerebrovascular disease n = 1 (1%)
•Coronary artery disease n = 1 (1%)
•Chronic kidney disease n = 2 (2%)
•Hashimoto disease n = 2 (2%)
•Graves disease n = 1 (1%)
•Multiple sclerosis n = 1 (1%)
•Behçet n = 1 (1%)
•Thyroid malignancy n = 1 (1%) 		99
Presenting complaint
Swelling
Dyspnea
Neck pain
Hoarse voice
Stridor
Dysphagia		n = 162 (89%)
n = 83 (50%)
n = 64 (41%)
n = 69 (41%)
n = 44 (31%)
n = 97 (63%) 		182
167
155
166
144
153
Duration of symptoms, mo4 (0.1-180)128
Prior thyroid statusHyperthyroidism n = 10 (7%)
Hypothyroidism n = 70 (46%)
Euthyroidism n = 66 (44%)
Subclinical hypothyroidism n = 3 (2%)
Subclinical hyperthyroidism n = 1 (1%)		150
Clinical status at reviewHyperthyroidism n = 23 (11%)
Hypothyroidism n = 8 (4%)
Euthyroidism n = 49 (23%)
Subclinical hypothyroidism n = 13 (6%)
Subclinical hyperthyroidism n = 2 (1%)
Sick euthyroidism n = 1 (0.5%)		212
Thyroid peroxidase antibody statusPositive n = 40 (43%)
Negative n = 52 (57%)		92
Thyrotropin receptor stimulating antibodyPositive n = 2 (20%)
Negative n = 8 (80%)		10
Thyroglobulin antibodyPositive n = 17 (27%)
Negative n = 45 (73%)		62
CRPHigh n = 18 (72%)25
ESRHigh n = 31 (97%)32
HistologyFibrous tissue n = 179 (100%)
Lymphocyte infiltrate n = 175 (98%)
Occlusive phlebitis n = 77 (43%)
Concomitant malignancy n = 1 (0.5%) 		179
Size, cm3.1 (1-13)59
Surgery No n = 37 (18%)
Tracheostomy n = 20 (10%)
Isthmectomy n = 13 (6%)
Thyroidectomy n = 70 (34%)
Hemithyroidectomy n = 25 (12%)
Surgery unspecified n = 40 (20%)		205
Weight of thyroid, g70 (7-417)23
Tracheal compression n = 122 (75%)162
Size of tracheal compression, mm8 (5–20) 10
Glucocorticoids n = 121 (70%)173
Duration of glucocorticoids, mo3 (0.1-60) 65
Prednisolone40 mg/d (0.5-100 mg)
Dose duration 3 mo (0.1-60 mo) 		53
Dexamethasone10 mg/d: 1
Dose not given: 2
No duration data		3
Methylprednisolone 62 mg/d (4-1000)
Dose duration 2 mo (0.1-24)		11
Betamethasone5.5 mg/d (3-8)
Dose duration 2 results: 4 and 11 mo 		4
Tamoxifen20 mg/d (10-40)
Dose duration 8 mo (1-48 mo)		28
Rituximab 1 g/d IV
Dose duration 3 mo 		3
Other treatmentAlfacalcidol (1 μg) n = 1
Azathioprine (40 mg/d, 125 mg/d, and 50 mg 3×/d) n = 4
Cortisone acetate (30 and 100 mg) n = 2
Fluorouracil n = 1
Warfarin n = 2
Mycophenolate mofetil 2 g/d n = 1
Follow-up duration, mo12 (0.1-566)120
Follow-up dataImproved n = 154 (90%)
Some improvement but not completely n = 5 (3%)
-Goiter resolved but ongoing hoarseness
-Continued right vocal cord paralysis but resolution of symptoms
-Postoperative dysphonia
-Residual hoarseness
-Ongoing vocal cord palsy
No improvement n = 12(7%)
-Goiter unchanged n = 6
-Recurrence n = 4
-Death from Riedel thyroid disease n = 2		171
Death10 (4.7%)212
Cause of deathPneumonia n = 1 (10%)
Acute myocardial infarct n = 1 (10%)
Riedel progression with systemic fibrosis n = 2 (20%)
Secondary hemorrhage from tracheostomy n = 1 (10%)
Hydronephrosis n = 1 (10%)
Unclear n = 1 (10%)
Pneumonia in combination with myxedema n = 1 (10%)
Septic shock 15 d after surgical debridement n = 1 (10%)
VariableCasesTotal No. of cases with information
SexMale n = 41 (19.3%)
Female n = 171 (80.7%)		212
Age, y47 (10.5-81) 212
Ethnicity Caucasian n = 55 (56%)
Asian n = 32 (33%)
African n = 5 (5%)
Black n = 2 (2%)
Arab n = 2 (2%)
Persian n = 2 (2%)		98
Smoking status Smokers n = 14 (16%)89
Comorbidities None n = 79 (80%)
•Asthma n = 3 (3%)
•Diabetes n = 7 (7%)
•Cerebrovascular disease n = 1 (1%)
•Coronary artery disease n = 1 (1%)
•Chronic kidney disease n = 2 (2%)
•Hashimoto disease n = 2 (2%)
•Graves disease n = 1 (1%)
•Multiple sclerosis n = 1 (1%)
•Behçet n = 1 (1%)
•Thyroid malignancy n = 1 (1%) 		99
Presenting complaint
Swelling
Dyspnea
Neck pain
Hoarse voice
Stridor
Dysphagia		n = 162 (89%)
n = 83 (50%)
n = 64 (41%)
n = 69 (41%)
n = 44 (31%)
n = 97 (63%) 		182
167
155
166
144
153
Duration of symptoms, mo4 (0.1-180)128
Prior thyroid statusHyperthyroidism n = 10 (7%)
Hypothyroidism n = 70 (46%)
Euthyroidism n = 66 (44%)
Subclinical hypothyroidism n = 3 (2%)
Subclinical hyperthyroidism n = 1 (1%)		150
Clinical status at reviewHyperthyroidism n = 23 (11%)
Hypothyroidism n = 8 (4%)
Euthyroidism n = 49 (23%)
Subclinical hypothyroidism n = 13 (6%)
Subclinical hyperthyroidism n = 2 (1%)
Sick euthyroidism n = 1 (0.5%)		212
Thyroid peroxidase antibody statusPositive n = 40 (43%)
Negative n = 52 (57%)		92
Thyrotropin receptor stimulating antibodyPositive n = 2 (20%)
Negative n = 8 (80%)		10
Thyroglobulin antibodyPositive n = 17 (27%)
Negative n = 45 (73%)		62
CRPHigh n = 18 (72%)25
ESRHigh n = 31 (97%)32
HistologyFibrous tissue n = 179 (100%)
Lymphocyte infiltrate n = 175 (98%)
Occlusive phlebitis n = 77 (43%)
Concomitant malignancy n = 1 (0.5%) 		179
Size, cm3.1 (1-13)59
Surgery No n = 37 (18%)
Tracheostomy n = 20 (10%)
Isthmectomy n = 13 (6%)
Thyroidectomy n = 70 (34%)
Hemithyroidectomy n = 25 (12%)
Surgery unspecified n = 40 (20%)		205
Weight of thyroid, g70 (7-417)23
Tracheal compression n = 122 (75%)162
Size of tracheal compression, mm8 (5–20) 10
Glucocorticoids n = 121 (70%)173
Duration of glucocorticoids, mo3 (0.1-60) 65
Prednisolone40 mg/d (0.5-100 mg)
Dose duration 3 mo (0.1-60 mo) 		53
Dexamethasone10 mg/d: 1
Dose not given: 2
No duration data		3
Methylprednisolone 62 mg/d (4-1000)
Dose duration 2 mo (0.1-24)		11
Betamethasone5.5 mg/d (3-8)
Dose duration 2 results: 4 and 11 mo 		4
Tamoxifen20 mg/d (10-40)
Dose duration 8 mo (1-48 mo)		28
Rituximab 1 g/d IV
Dose duration 3 mo 		3
Other treatmentAlfacalcidol (1 μg) n = 1
Azathioprine (40 mg/d, 125 mg/d, and 50 mg 3×/d) n = 4
Cortisone acetate (30 and 100 mg) n = 2
Fluorouracil n = 1
Warfarin n = 2
Mycophenolate mofetil 2 g/d n = 1
Follow-up duration, mo12 (0.1-566)120
Follow-up dataImproved n = 154 (90%)
Some improvement but not completely n = 5 (3%)
-Goiter resolved but ongoing hoarseness
-Continued right vocal cord paralysis but resolution of symptoms
-Postoperative dysphonia
-Residual hoarseness
-Ongoing vocal cord palsy
No improvement n = 12(7%)
-Goiter unchanged n = 6
-Recurrence n = 4
-Death from Riedel thyroid disease n = 2		171
Death10 (4.7%)212
Cause of deathPneumonia n = 1 (10%)
Acute myocardial infarct n = 1 (10%)
Riedel progression with systemic fibrosis n = 2 (20%)
Secondary hemorrhage from tracheostomy n = 1 (10%)
Hydronephrosis n = 1 (10%)
Unclear n = 1 (10%)
Pneumonia in combination with myxedema n = 1 (10%)
Septic shock 15 d after surgical debridement n = 1 (10%)

Abbreviations: CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IV, intravenous.

Table 1.
Open in new tab

Meta-analysis of 212 individuals with Riedel thyroiditis

VariableCasesTotal No. of cases with information
SexMale n = 41 (19.3%)
Female n = 171 (80.7%)		212
Age, y47 (10.5-81) 212
Ethnicity Caucasian n = 55 (56%)
Asian n = 32 (33%)
African n = 5 (5%)
Black n = 2 (2%)
Arab n = 2 (2%)
Persian n = 2 (2%)		98
Smoking status Smokers n = 14 (16%)89
Comorbidities None n = 79 (80%)
•Asthma n = 3 (3%)
•Diabetes n = 7 (7%)
•Cerebrovascular disease n = 1 (1%)
•Coronary artery disease n = 1 (1%)
•Chronic kidney disease n = 2 (2%)
•Hashimoto disease n = 2 (2%)
•Graves disease n = 1 (1%)
•Multiple sclerosis n = 1 (1%)
•Behçet n = 1 (1%)
•Thyroid malignancy n = 1 (1%) 		99
Presenting complaint
Swelling
Dyspnea
Neck pain
Hoarse voice
Stridor
Dysphagia		n = 162 (89%)
n = 83 (50%)
n = 64 (41%)
n = 69 (41%)
n = 44 (31%)
n = 97 (63%) 		182
167
155
166
144
153
Duration of symptoms, mo4 (0.1-180)128
Prior thyroid statusHyperthyroidism n = 10 (7%)
Hypothyroidism n = 70 (46%)
Euthyroidism n = 66 (44%)
Subclinical hypothyroidism n = 3 (2%)
Subclinical hyperthyroidism n = 1 (1%)		150
Clinical status at reviewHyperthyroidism n = 23 (11%)
Hypothyroidism n = 8 (4%)
Euthyroidism n = 49 (23%)
Subclinical hypothyroidism n = 13 (6%)
Subclinical hyperthyroidism n = 2 (1%)
Sick euthyroidism n = 1 (0.5%)		212
Thyroid peroxidase antibody statusPositive n = 40 (43%)
Negative n = 52 (57%)		92
Thyrotropin receptor stimulating antibodyPositive n = 2 (20%)
Negative n = 8 (80%)		10
Thyroglobulin antibodyPositive n = 17 (27%)
Negative n = 45 (73%)		62
CRPHigh n = 18 (72%)25
ESRHigh n = 31 (97%)32
HistologyFibrous tissue n = 179 (100%)
Lymphocyte infiltrate n = 175 (98%)
Occlusive phlebitis n = 77 (43%)
Concomitant malignancy n = 1 (0.5%) 		179
Size, cm3.1 (1-13)59
Surgery No n = 37 (18%)
Tracheostomy n = 20 (10%)
Isthmectomy n = 13 (6%)
Thyroidectomy n = 70 (34%)
Hemithyroidectomy n = 25 (12%)
Surgery unspecified n = 40 (20%)		205
Weight of thyroid, g70 (7-417)23
Tracheal compression n = 122 (75%)162
Size of tracheal compression, mm8 (5–20) 10
Glucocorticoids n = 121 (70%)173
Duration of glucocorticoids, mo3 (0.1-60) 65
Prednisolone40 mg/d (0.5-100 mg)
Dose duration 3 mo (0.1-60 mo) 		53
Dexamethasone10 mg/d: 1
Dose not given: 2
No duration data		3
Methylprednisolone 62 mg/d (4-1000)
Dose duration 2 mo (0.1-24)		11
Betamethasone5.5 mg/d (3-8)
Dose duration 2 results: 4 and 11 mo 		4
Tamoxifen20 mg/d (10-40)
Dose duration 8 mo (1-48 mo)		28
Rituximab 1 g/d IV
Dose duration 3 mo 		3
Other treatmentAlfacalcidol (1 μg) n = 1
Azathioprine (40 mg/d, 125 mg/d, and 50 mg 3×/d) n = 4
Cortisone acetate (30 and 100 mg) n = 2
Fluorouracil n = 1
Warfarin n = 2
Mycophenolate mofetil 2 g/d n = 1
Follow-up duration, mo12 (0.1-566)120
Follow-up dataImproved n = 154 (90%)
Some improvement but not completely n = 5 (3%)
-Goiter resolved but ongoing hoarseness
-Continued right vocal cord paralysis but resolution of symptoms
-Postoperative dysphonia
-Residual hoarseness
-Ongoing vocal cord palsy
No improvement n = 12(7%)
-Goiter unchanged n = 6
-Recurrence n = 4
-Death from Riedel thyroid disease n = 2		171
Death10 (4.7%)212
Cause of deathPneumonia n = 1 (10%)
Acute myocardial infarct n = 1 (10%)
Riedel progression with systemic fibrosis n = 2 (20%)
Secondary hemorrhage from tracheostomy n = 1 (10%)
Hydronephrosis n = 1 (10%)
Unclear n = 1 (10%)
Pneumonia in combination with myxedema n = 1 (10%)
Septic shock 15 d after surgical debridement n = 1 (10%)
VariableCasesTotal No. of cases with information
SexMale n = 41 (19.3%)
Female n = 171 (80.7%)		212
Age, y47 (10.5-81) 212
Ethnicity Caucasian n = 55 (56%)
Asian n = 32 (33%)
African n = 5 (5%)
Black n = 2 (2%)
Arab n = 2 (2%)
Persian n = 2 (2%)		98
Smoking status Smokers n = 14 (16%)89
Comorbidities None n = 79 (80%)
•Asthma n = 3 (3%)
•Diabetes n = 7 (7%)
•Cerebrovascular disease n = 1 (1%)
•Coronary artery disease n = 1 (1%)
•Chronic kidney disease n = 2 (2%)
•Hashimoto disease n = 2 (2%)
•Graves disease n = 1 (1%)
•Multiple sclerosis n = 1 (1%)
•Behçet n = 1 (1%)
•Thyroid malignancy n = 1 (1%) 		99
Presenting complaint
Swelling
Dyspnea
Neck pain
Hoarse voice
Stridor
Dysphagia		n = 162 (89%)
n = 83 (50%)
n = 64 (41%)
n = 69 (41%)
n = 44 (31%)
n = 97 (63%) 		182
167
155
166
144
153
Duration of symptoms, mo4 (0.1-180)128
Prior thyroid statusHyperthyroidism n = 10 (7%)
Hypothyroidism n = 70 (46%)
Euthyroidism n = 66 (44%)
Subclinical hypothyroidism n = 3 (2%)
Subclinical hyperthyroidism n = 1 (1%)		150
Clinical status at reviewHyperthyroidism n = 23 (11%)
Hypothyroidism n = 8 (4%)
Euthyroidism n = 49 (23%)
Subclinical hypothyroidism n = 13 (6%)
Subclinical hyperthyroidism n = 2 (1%)
Sick euthyroidism n = 1 (0.5%)		212
Thyroid peroxidase antibody statusPositive n = 40 (43%)
Negative n = 52 (57%)		92
Thyrotropin receptor stimulating antibodyPositive n = 2 (20%)
Negative n = 8 (80%)		10
Thyroglobulin antibodyPositive n = 17 (27%)
Negative n = 45 (73%)		62
CRPHigh n = 18 (72%)25
ESRHigh n = 31 (97%)32
HistologyFibrous tissue n = 179 (100%)
Lymphocyte infiltrate n = 175 (98%)
Occlusive phlebitis n = 77 (43%)
Concomitant malignancy n = 1 (0.5%) 		179
Size, cm3.1 (1-13)59
Surgery No n = 37 (18%)
Tracheostomy n = 20 (10%)
Isthmectomy n = 13 (6%)
Thyroidectomy n = 70 (34%)
Hemithyroidectomy n = 25 (12%)
Surgery unspecified n = 40 (20%)		205
Weight of thyroid, g70 (7-417)23
Tracheal compression n = 122 (75%)162
Size of tracheal compression, mm8 (5–20) 10
Glucocorticoids n = 121 (70%)173
Duration of glucocorticoids, mo3 (0.1-60) 65
Prednisolone40 mg/d (0.5-100 mg)
Dose duration 3 mo (0.1-60 mo) 		53
Dexamethasone10 mg/d: 1
Dose not given: 2
No duration data		3
Methylprednisolone 62 mg/d (4-1000)
Dose duration 2 mo (0.1-24)		11
Betamethasone5.5 mg/d (3-8)
Dose duration 2 results: 4 and 11 mo 		4
Tamoxifen20 mg/d (10-40)
Dose duration 8 mo (1-48 mo)		28
Rituximab 1 g/d IV
Dose duration 3 mo 		3
Other treatmentAlfacalcidol (1 μg) n = 1
Azathioprine (40 mg/d, 125 mg/d, and 50 mg 3×/d) n = 4
Cortisone acetate (30 and 100 mg) n = 2
Fluorouracil n = 1
Warfarin n = 2
Mycophenolate mofetil 2 g/d n = 1
Follow-up duration, mo12 (0.1-566)120
Follow-up dataImproved n = 154 (90%)
Some improvement but not completely n = 5 (3%)
-Goiter resolved but ongoing hoarseness
-Continued right vocal cord paralysis but resolution of symptoms
-Postoperative dysphonia
-Residual hoarseness
-Ongoing vocal cord palsy
No improvement n = 12(7%)
-Goiter unchanged n = 6
-Recurrence n = 4
-Death from Riedel thyroid disease n = 2		171
Death10 (4.7%)212
Cause of deathPneumonia n = 1 (10%)
Acute myocardial infarct n = 1 (10%)
Riedel progression with systemic fibrosis n = 2 (20%)
Secondary hemorrhage from tracheostomy n = 1 (10%)
Hydronephrosis n = 1 (10%)
Unclear n = 1 (10%)
Pneumonia in combination with myxedema n = 1 (10%)
Septic shock 15 d after surgical debridement n = 1 (10%)

Abbreviations: CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IV, intravenous.

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