Dabelic Nina, Jukic Tomislav, Labar Zeljka, Novosel Suncica A, Matesa Neven, Kusic Zvonko
Department of Oncology and Nuclear Medicine, Sisters of Mercy University Hospital, Vinogradska 29, 10000 Zagreb, Croatia.
Croat Med J. 2003 Apr;44(2):239-41.
A 46-year-old woman with clinical diagnosis of Riedel's thyroiditis was admitted to our Department, presenting with dyspnea, dysphagia, fatigue, and hoarseness. Previously, she had been diagnosed with Hashimoto's thyroiditis and hypothyroidism. The disease had a progressive course and had lasted for a year before the definitive diagnosis of Riedel's thyroiditis was confirmed and treated with methylprednisolone, 12 mg daily, without success. We started therapy with tamoxifen, 10 mg twice a day, together with methylprednisolone, 16 mg daily, and L-thyroxin substitution therapy. The follow-up lasted for one year. Treatment with tamoxifen led to a significant subjective improvement and objective changes, confirmed by regular clinical examinations, ultrasonography, and computed tomography of the neck. After 8 months of therapy, the patient had no compression symptoms and goiter decreased in estimated weight from 105 g to 63 g according to ultrasound measurements. The patient underwent partial thyroidectomy at 10 months after diagnosis of Riedel's thyroiditis. Histopathology confirmed the diagnosis of Riedel's thyroiditis. Our report indicates that tamoxifen can be a valuable drug therapy in the treatment of Riedel's thyroiditis.
一名临床诊断为里德耳甲状腺炎的46岁女性入住我科，表现为呼吸困难、吞咽困难、乏力和声音嘶哑。此前，她被诊断为桥本甲状腺炎和甲状腺功能减退症。该疾病呈进行性发展，在确诊里德耳甲状腺炎并接受每日12毫克甲泼尼龙治疗之前已持续了一年，但治疗无效。我们开始使用他莫昔芬，每日两次，每次10毫克，联合每日16毫克甲泼尼龙以及左甲状腺素替代疗法进行治疗。随访持续了一年。他莫昔芬治疗带来了显著的主观改善和客观变化，这通过定期临床检查、超声检查以及颈部计算机断层扫描得以证实。治疗8个月后，患者无压迫症状，根据超声测量，甲状腺肿估计重量从105克降至63克。该患者在被诊断为里德耳甲状腺炎10个月后接受了甲状腺部分切除术。组织病理学证实了里德耳甲状腺炎的诊断。我们的报告表明，他莫昔芬在治疗里德耳甲状腺炎方面可能是一种有价值的药物疗法。
