Riedel's thyroiditis

Treatment with tamoxifen

J. Few, N. W. Thompson, P. Angelos, D. Simeone, T. Giordano, T. Reeve, Ian D Hay, S. Taylor

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background. Riedel's thyroiditis is an often disabling disease with clinical and histologic similarity to several other fibrous inflammatory disorders. Surgical treatment alone is often unsatisfactory in permanently alleviating airway compression, dysphagia, neck immobility, pain, or chronic fatigue syndrome. Investigation of drugs shown to be of benefit in the treatment of related fibrous disorders in which hormonal factors or inflammatory deregulation appear to be important is indicated. Tamoxifen has not been previously used in the treatment of Riedel's thyroiditis. Methods. Four patients with clinical and histologic diagnoses of Riedel's thyroiditis were evaluated before and after treatment with tamoxifen. Each had progressive symptomatic disease of 3 to 16 years' duration despite one or more surgical procedures and steroid therapy. Subjective improvement was noted in all cases, and objective changes were confirmed by periodic physical and computed tomographic examinations. Results. Patients have been monitored for 1 to 4 years with subjective improvement in 100% and objective disease regression ranging from 50% to 100% in all patients. One patient had complete regression within 6 months, and another had more than 50% regression within 3 months. All have returned to predisease activity levels. There were no significant side effects of the therapy. Conclusions. Tamoxifen has proved to be the most effective drug therapy available for managing Riedel's thyroiditis. Our studies suggest that this is unrelated to antiestrogen activity. Tamoxifen's effectiveness may be caused by a mechanism by which it stimulates the release of transforming growth factor-β, which may inhibit the fibroblastic proliferation characteristic of Riedel's thyroiditis.

Original languageEnglish (US)
Pages (from-to)993-999
Number of pages7
JournalSurgery
Volume120
Issue number6
StatePublished - 1996
Externally publishedYes

Fingerprint

Thyroiditis
Tamoxifen
Therapeutics
Chronic Fatigue Syndrome
Estrogen Receptor Modulators
Neck Pain
Transforming Growth Factors
Deglutition Disorders
Steroids
Drug Therapy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Surgery

Cite this

Few, J., Thompson, N. W., Angelos, P., Simeone, D., Giordano, T., Reeve, T., ... Taylor, S. (1996). Riedel's thyroiditis: Treatment with tamoxifen. Surgery, 120(6), 993-999.

Riedel's thyroiditis : Treatment with tamoxifen. / Few, J.; Thompson, N. W.; Angelos, P.; Simeone, D.; Giordano, T.; Reeve, T.; Hay, Ian D; Taylor, S.

In: Surgery, Vol. 120, No. 6, 1996, p. 993-999.

Research output: Contribution to journalArticle

Few, J, Thompson, NW, Angelos, P, Simeone, D, Giordano, T, Reeve, T, Hay, ID & Taylor, S 1996, 'Riedel's thyroiditis: Treatment with tamoxifen', Surgery, vol. 120, no. 6, pp. 993-999.
Few J, Thompson NW, Angelos P, Simeone D, Giordano T, Reeve T et al. Riedel's thyroiditis: Treatment with tamoxifen. Surgery. 1996;120(6):993-999.
Few, J. ; Thompson, N. W. ; Angelos, P. ; Simeone, D. ; Giordano, T. ; Reeve, T. ; Hay, Ian D ; Taylor, S. / Riedel's thyroiditis : Treatment with tamoxifen. In: Surgery. 1996 ; Vol. 120, No. 6. pp. 993-999.
@article{db2c75d8bfca4ee49a8c36c4b6501dfd,
title = "Riedel's thyroiditis: Treatment with tamoxifen",
abstract = "Background. Riedel's thyroiditis is an often disabling disease with clinical and histologic similarity to several other fibrous inflammatory disorders. Surgical treatment alone is often unsatisfactory in permanently alleviating airway compression, dysphagia, neck immobility, pain, or chronic fatigue syndrome. Investigation of drugs shown to be of benefit in the treatment of related fibrous disorders in which hormonal factors or inflammatory deregulation appear to be important is indicated. Tamoxifen has not been previously used in the treatment of Riedel's thyroiditis. Methods. Four patients with clinical and histologic diagnoses of Riedel's thyroiditis were evaluated before and after treatment with tamoxifen. Each had progressive symptomatic disease of 3 to 16 years' duration despite one or more surgical procedures and steroid therapy. Subjective improvement was noted in all cases, and objective changes were confirmed by periodic physical and computed tomographic examinations. Results. Patients have been monitored for 1 to 4 years with subjective improvement in 100{\%} and objective disease regression ranging from 50{\%} to 100{\%} in all patients. One patient had complete regression within 6 months, and another had more than 50{\%} regression within 3 months. All have returned to predisease activity levels. There were no significant side effects of the therapy. Conclusions. Tamoxifen has proved to be the most effective drug therapy available for managing Riedel's thyroiditis. Our studies suggest that this is unrelated to antiestrogen activity. Tamoxifen's effectiveness may be caused by a mechanism by which it stimulates the release of transforming growth factor-β, which may inhibit the fibroblastic proliferation characteristic of Riedel's thyroiditis.",
author = "J. Few and Thompson, {N. W.} and P. Angelos and D. Simeone and T. Giordano and T. Reeve and Hay, {Ian D} and S. Taylor",
year = "1996",
language = "English (US)",
volume = "120",
pages = "993--999",
journal = "Surgery (United States)",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Riedel's thyroiditis

T2 - Treatment with tamoxifen

AU - Few, J.

AU - Thompson, N. W.

AU - Angelos, P.

AU - Simeone, D.

AU - Giordano, T.

AU - Reeve, T.

AU - Hay, Ian D

AU - Taylor, S.

PY - 1996

Y1 - 1996

N2 - Background. Riedel's thyroiditis is an often disabling disease with clinical and histologic similarity to several other fibrous inflammatory disorders. Surgical treatment alone is often unsatisfactory in permanently alleviating airway compression, dysphagia, neck immobility, pain, or chronic fatigue syndrome. Investigation of drugs shown to be of benefit in the treatment of related fibrous disorders in which hormonal factors or inflammatory deregulation appear to be important is indicated. Tamoxifen has not been previously used in the treatment of Riedel's thyroiditis. Methods. Four patients with clinical and histologic diagnoses of Riedel's thyroiditis were evaluated before and after treatment with tamoxifen. Each had progressive symptomatic disease of 3 to 16 years' duration despite one or more surgical procedures and steroid therapy. Subjective improvement was noted in all cases, and objective changes were confirmed by periodic physical and computed tomographic examinations. Results. Patients have been monitored for 1 to 4 years with subjective improvement in 100% and objective disease regression ranging from 50% to 100% in all patients. One patient had complete regression within 6 months, and another had more than 50% regression within 3 months. All have returned to predisease activity levels. There were no significant side effects of the therapy. Conclusions. Tamoxifen has proved to be the most effective drug therapy available for managing Riedel's thyroiditis. Our studies suggest that this is unrelated to antiestrogen activity. Tamoxifen's effectiveness may be caused by a mechanism by which it stimulates the release of transforming growth factor-β, which may inhibit the fibroblastic proliferation characteristic of Riedel's thyroiditis.

AB - Background. Riedel's thyroiditis is an often disabling disease with clinical and histologic similarity to several other fibrous inflammatory disorders. Surgical treatment alone is often unsatisfactory in permanently alleviating airway compression, dysphagia, neck immobility, pain, or chronic fatigue syndrome. Investigation of drugs shown to be of benefit in the treatment of related fibrous disorders in which hormonal factors or inflammatory deregulation appear to be important is indicated. Tamoxifen has not been previously used in the treatment of Riedel's thyroiditis. Methods. Four patients with clinical and histologic diagnoses of Riedel's thyroiditis were evaluated before and after treatment with tamoxifen. Each had progressive symptomatic disease of 3 to 16 years' duration despite one or more surgical procedures and steroid therapy. Subjective improvement was noted in all cases, and objective changes were confirmed by periodic physical and computed tomographic examinations. Results. Patients have been monitored for 1 to 4 years with subjective improvement in 100% and objective disease regression ranging from 50% to 100% in all patients. One patient had complete regression within 6 months, and another had more than 50% regression within 3 months. All have returned to predisease activity levels. There were no significant side effects of the therapy. Conclusions. Tamoxifen has proved to be the most effective drug therapy available for managing Riedel's thyroiditis. Our studies suggest that this is unrelated to antiestrogen activity. Tamoxifen's effectiveness may be caused by a mechanism by which it stimulates the release of transforming growth factor-β, which may inhibit the fibroblastic proliferation characteristic of Riedel's thyroiditis.

UR - http://www.scopus.com/inward/record.url?scp=0029965042&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029965042&partnerID=8YFLogxK

M3 - Article

VL - 120

SP - 993

EP - 999

JO - Surgery (United States)

JF - Surgery (United States)

SN - 0039-6060

IS - 6

ER -