How is chronic fibrous thyroiditis caused?

summary

Chronic fibrous thyroiditis (CFT) is a rare thyroid inflammation characterized by the replacement of normal thyroid tissue by a large number of dense fibrous tissue. Riedel (1897) described this disease for the first time, so it is also called Riedel thyroiditis (RT). RT also has many names, such as invasive fibrous thyroiditis, chronic woody thyroiditis, Riedel goiter, chronic sclerosing thyroiditis and so on. Riedel's study under microscope showed that RT had no characteristics of malignant tumor, and simple wedge resection of thyroid isthmus could effectively relieve the symptoms of tracheal compression. How is chronic fibrous thyroiditis caused? Let's talk about it now.

How is chronic fibrous thyroiditis caused?

The etiology of RT is not clear. Some people think that RT is the result of autoimmune reaction. Another theory thinks that RT belongs to primary fibrosis disease and is a part of systemic fibrosclerosis. The results showed that RT was an autoimmune reaction. The proportion of anti thyroid antibody detected in RT patients was as high as 67%; ② RT is characterized by infiltration of lymphocytes and plasma cells; ③ Focal vasculitis is another common pathological feature of RT; ④ Some patients with RT have good therapeutic effect on adrenocortical hormone.

However, the lymphocyte and serum complement levels of the patients were normal, which did not seem to support RT as an autoimmune response. The increase of antithyroid antibody level may be due to other reasons, such as the destruction and release of thyroid tissue in primary fibrosis, which can cause the immune system reaction and lead to the increase of antithyroid antibody level. Multifocal fibrosclerosis can occur in about one third of RT cases, such as retroperitoneal fibrosis, retroorbital fibrous pseudotumor, sclerosing cholangitis, mediastinal fibrosis, pulmonary fibrosis, etc. Fibrotic RT may also be associated with transforming growth factor- β 1(transforming growth factor- β 1，TGF- β 1) About.

The clinical manifestations of RT are often related to local compression symptoms, such as dyspnea and dysphagia after compression of trachea and esophagus, hoarseness, aphasia or cough after involvement of recurrent laryngeal nerve. If the thyroid tissue is completely fibrotic, hypothyroidism may occur. Fibrosis of the parathyroid gland can lead to hypoparathyroidism. The rare subcutaneous fibrosclerosis may also occur.

matters needing attention

More iodized salt should be added; Appropriate amount of kelp, laver, iodized salt, iodized soy sauce, iodized egg and bread can be used. Supply sufficient protein, protein supplement can choose eggs, milk, all kinds of meat, fish; Plant protein can be complementary, such as a variety of bean products, soybeans, etc;