scholarly journals Distinct histopathological features of Hashimoto’s thyroiditis with respect to IgG4-related disease

2012 ◽  
Vol 25 (8) ◽  
pp. 1086-1097 ◽  
Author(s):  
Yaqiong Li ◽  
Gengyin Zhou ◽  
Takashi Ozaki ◽  
Eijun Nishihara ◽  
Fumio Matsuzuka ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Histopathological Features ◽  
Related Disease ◽  
Igg4 Related Disease

scholarly journals IgG4-related thyroiditis: a case report and review of literature

2014 ◽  
Vol 2014 ◽  
Author(s):  
Mahmud Abo Salook ◽  
Carlos Benbassat ◽  
Yulia Strenov ◽  
Amit Tirosh
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Systemic Disease ◽  
Hashimoto's Thyroiditis ◽  
List Type ◽  
Review Of Literature ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Aggressive Form ◽  
Learning Points ◽  
Very High

Summary A 55-year-old male, with a positive medical history for hypothyroidism, treated with stable doses for years was admitted with subacute thyroiditis and a feeling of pain and pressure in the neck. Laboratory tests showed decrease in TSH levels, elevated erythrocyte sedimentation rate, and very high antithyroid antibodies. Owing to enlarging goiter and exacerbation in the patient's complaints, he was operated with excision of a fibrotic and enlarged thyroid lobe. Elevated IgG4 plasma levels and high IgG4/IgG plasma cell ratio on immunohistochemistry led to the diagnosis of IgG4-mediated thyroiditis. We concluded that IgG4-thyroiditis and IgG4-related disease should be considered in all patients with an aggressive form of Hashimoto's thyroiditis. Learning points IgG4-related disease is a systemic disease that includes several syndromes; IgG4-related thyroiditis is one among them. IgG4-thyroiditis should be considered in all patients with an aggressive form of Hashimoto's thyroiditis. Patients with suspected IgG4-thyroiditis should have blood tested for IgG4/IgG ratio and appropriate immunohistochemical staining if possible.

scholarly journals IgG4-related Hashimoto’s thyroiditis – A new variant of a well known disease

2014 ◽  
Vol 58 (8) ◽  
pp. 862-868 ◽  
Author(s):  
Henrique Vara Luiz ◽  
Diogo Gonçalves ◽  
Tiago Nunes da Silva ◽  
Isabel Nascimento ◽  
Ana Ribeiro ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Plasma Cells ◽  
Hashimoto's Thyroiditis ◽  
High Power Field ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Inflammatory Parameters ◽  
First Case ◽  
New Variant ◽  
Serum Igg4

Hashimoto’s thyroiditis (HT) has been characterized for many years as a well-defined clinicopathologic entity, but is now considered a heterogeneous disease. IgG4-related HT is a new subtype characterized by thyroid inflammation rich in IgG4-positive plasma cells and marked fibrosis. It may be part of the systemic IgG4-related disease. We report a case of a 56-year-old Portuguese man who presented with a one-month history of progressive neck swelling and dysphagia. Laboratory testing revealed increased inflammatory parameters, subclinical hypothyroidism and very high levels of thyroid autoantibodies. Cervical ultrasound (US) demonstrated an enlarged and heterogeneous thyroid gland and two hypoechoic nodules. US-guided fine needle aspiration cytology was consistent with lymphocytic thyroiditis. The patient was submitted to total thyroidectomy and microscopic examination identified typical findings of HT, marked fibrosis limited within the thyroid capsule and lymphoplasmacytic infiltration, with >50 IgG4-positive plasma cells per high-power field and an IgG4/IgG ratio of >40%. After surgery, serum IgG4 concentration was high-normal. Symptoms relief and reduction in laboratory inflammatory parameters were noticed. Thyroid function is controlled with levothyroxine. To our knowledge we report the first case of IgG4-related HT in a non-Asian patient. We also perform a review of the literature regarding IgG4-related disease and IgG4-related HT. Our case highlights this new variant of the well known HT, and helps physicians in recognizing its main clinical features, allowing for proper diagnosis and treatment.

IgG4-related disease of the thyroid gland

2021 ◽  
Vol 14 (3) ◽  
pp. e238177
Author(s):  
Tânia Matos ◽  
Margarida Mendes de Almeida ◽  
Lucas Batista ◽  
Sónia do Vale
Keyword(s):  
Thyroid Gland ◽  
Hashimoto’S Thyroiditis ◽  
Plasma Cells ◽  
Needle Aspiration ◽  
Hashimoto's Thyroiditis ◽  
Fine Needle ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Cervical Swelling ◽  
Reduced Mobility

IgG4-thyroid-related disease (TRD) represents an uncommon spectrum of diseases, with four subcategories established so far, IgG4-related Hashimoto’s thyroiditis, fibrosing variant of Hashimoto’s thyroiditis, Riedel’s thyroiditis and Graves disease with elevated IgG4 levels. We report the case of a 59-year-old woman presenting with painless cervical swelling and hypothyroidism. Thyroid gland was enlarged and distinctively very hard, with reduced mobility. Neck ultrasonography showed multiple nodularity and diffuse thyroid enlargement, which on CT scan conditioned slight deviation of the airway. Fine-needle aspiration of the biggest nodule was suggestive of lymphocytic thyroiditis. She developed compressive symptoms and was submitted to total thyroidectomy. Histology of the thyroid revealed extensive areas of fibrosis, oncocytic cells and lymphoplasmacytic infiltrates. Immunohistochemistry confirmed the predominance of IgG4-secreting plasma cells. IgG4-TRD is characterised by a rapidly progressive and destructive thyroiditis process. Typical presentation can often mimic malignancy; hence, an opportune recognition of IgG4-TRD may avoid unnecessary burdens.

A small subgroup of Hashimoto’s thyroiditis is associated with IgG4-related disease

2015 ◽  
Vol 468 (3) ◽  
pp. 321-327 ◽  
Author(s):  
Friedrich Jokisch ◽  
Irene Kleinlein ◽  
Bernhard Haller ◽  
Tanja Seehaus ◽  
Heinrich Fuerst ◽  
...  
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Hashimoto's Thyroiditis ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Small Subgroup

scholarly journals Ultrasonography findings in immunoglobulin G4-related lymphadenopathy: a report of two cases

2020 ◽  
Vol 1 (1) ◽  
pp. 105
Author(s):  
Tsuyoshi Morisaki ◽  
Takahiro Fukuhara ◽  
Eriko Matsuda ◽  
Sueyoshi Moritani ◽  
Naritomo Miyake ◽  
...  
Keyword(s):  
Ultrasound Scanning ◽  
Immunoglobulin G4 ◽  
Doppler Examination ◽  
Histopathological Findings ◽  
Histopathological Features ◽  
Related Disease ◽  
Igg4 Related Disease

Lymphadenopathy is frequently observed in immunoglobulin G4 (IgG4)-related disease in some cases, and such cases are known as IgG4-related lymphadenopathy. The ultrasonography findings associated with IgG4-related lymphadenopathy have not been described in previous reports. Herein, we describe ultrasonography findings in two cases of IgG4-related lymphadenopathy in conjunction with histopathological findings. Combined ultrasound scanning with Doppler examination accurately represented the specific histopathological features of IgG4-related lymphadenopathy.

scholarly journals IgG4-related disease: can non-classical histopathological features or the examination of clinically uninvolved tissues be helpful in the diagnosis?

2012 ◽  
Vol 65 (11) ◽  
pp. 963-969 ◽  
Author(s):  
Emma L Culver ◽  
Adrian C Bateman
Keyword(s):  
Cell Count ◽  
Plasma Cell ◽  
Supporting Evidence ◽  
Diagnostic Features ◽  
Histopathological Features ◽  
Related Disease ◽  
Igg4 Related Disease ◽  
Multisystem Involvement ◽  
Immune Mediated ◽  
Serum Igg4

IgG4-related disease (IgG4-RD) is an increasingly recognised inflammatory and fibrosing condition that commonly shows multisystem involvement. The disease may mimic malignancy and other inflammatory or immune-mediated disorders, but usually has a good response to corticosteroid therapy, underlining the requirement for recognition of the condition. Accurate diagnosis requires careful interpretation of varying combinations of serum IgG4 levels, radiological features and characteristic histopathological appearances within an appropriate clinical setting. The presence of ‘classical’ histopathological features together with an elevated tissue IgG4+ plasma cell count and IgG4 to IgG ratio is often diagnostic and at the very least can strongly support a clinicopathological diagnosis of IgG4-RD. The authors describe the most recent diagnostic criteria for IgG4-RD, especially the histopathological features. The authors then discuss the merits of examining tissues that may be more easily obtainable than those that commonly show the ‘classical’ histopathological features, but within which not all of these ‘diagnostic’ features may be present. The authors conclude that while a combination of ‘classical’ histopathological features and an elevated tissue IgG4+ plasma cell count is the gold standard for diagnosis, examination of tissues that show some but not all of these features can, in the appropriate context, provide useful supporting evidence for a clinicopathological diagnosis of IgG4-RD.

scholarly journals Research Progress on IgG4-Related Hashimoto’s Thyroiditis

2015 ◽  
Vol 4 (2) ◽  
pp. 40-44
Author(s):  
Guang Ji
Keyword(s):  
Hashimoto’S Thyroiditis ◽  
Early Stage ◽  
Follicular Epithelium ◽  
Research Progress ◽  
Hashimoto's Thyroiditis ◽  
Systemic Autoimmune Disease ◽  
Thyroid Peroxidase ◽  
Multiple Organs ◽  
Igg4 Related Disease ◽  
Thyroid Peroxidase Antibody

AbstractIgG4-related disease is a systemic autoimmune disease with unknown cause and involves multiple organs and tissues. This disease became one of research hotspots in the last ten years. IgG4-related Hashimoto’s thyroiditis (HT) exhibits unique clinical pathological characteristics: serum-free thyroxine reduction and increases in thyroid peroxidase antibody and IgG4; massive IgG4-positive plasmocyte infiltration in tissues; significant matrix fibrosis; and severe degeneration of thyroid follicular epithelium. IgG4-related HT is a subtype of HT; it presents relatively good therapeutic effect after thyroxine treatment. Cortical hormones can be used for IgG4 HT patients who may suffer from hypothyroidism with significant thyroid injury during early stage to constrain immune injury. This thesis summarizes clinical and pathological histology of IgG4-related HT based on its characteristics.

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