Document Detail


Riedel's thyroiditis: treatment with tamoxifen.
MedLine Citation:
PMID:  8957485     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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-beta, which may inhibit the fibroblastic proliferation characteristic of Riedel's thyroiditis.
Authors:
J Few; N W Thompson; P Angelos; D Simeone; T Giordano; T Reeve
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Publication Detail:
Type:  Case Reports; Clinical Trial; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  120     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-10     Completed Date:  1997-01-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  993-8; discussion 998-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Michigan, Ann Arbor, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Male
Middle Aged
Neck / radionuclide imaging
Remission Induction
Tamoxifen / therapeutic use*
Thyroiditis / drug therapy*,  radiography
Tomography, X-Ray Computed
Chemical
Reg. No./Substance:
10540-29-1/Tamoxifen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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