Recurrent Parotid Gland Swelling Research Articles

Differences in presentation between paediatric- and adult-onset primary Sjögren's syndrome patients.

Primary Sjögren's syndrome (pSS) is a rare disease in paediatric patients. Presenting symptoms differ from those in adult patients. The aim of this study was to evaluate presenting symptoms, classification criteria and clinical assessments, including salivary gland ultrasonography (SGUS), at disease onset in paediatric and adult patients with pSS. Data of 23 paediatric- and 33 adult-onset patients with pSS were obtained from our standardised multidisciplinary REpSULT and RESULT cohorts, respectively. Clinical, patient-reported, serological, functional, biopsy and SGUS parameters were compared. In paediatric-onset pSS (pedSS) patients, recurrent parotid gland swelling (91% vs. 49%, p<0.001) and fever (30% vs. 3%, p=0.006) were more often present than in adult-onset patients. In contrast, sicca symptoms of mouth (52% vs. 79%, p=0.046) and eyes (26% vs. 73%, p<0.001) were less common in pedSS patients. In paediatric patients, the entry criteria of the ACR/EULAR classification were most often met due to activity in the glandular domain of the ESSDAI. When applying the ACR/EULAR classification criteria, only 78% of pedSS fulfilled these criteria compared to 100% of adult patients. Abnormal glandular function tests had a greater contribution to fulfilling the criteria in adults, while the biopsy had a greater contribution in paediatric patients. Anti-SSA/Ro serology had similar contribution for both cohorts. SGUS Hocevar score was significantly higher in paediatric compared to adult patients (median 25 vs. 18, p=0.004). PedSS has a different presentation than adult-onset pSS. Recurrent parotid gland swelling in paediatric patients should alert clinicians to the potential presence of pSS.

THE DIAGNOSTIC CHALLENGE OF CHILDHOOD PRIMARY SJÖGREN SYNDROME: A SINGLE-CENTER CASE SERIES

<h3>Background</h3> Primary Sjögren syndrome (pSS) is a chronic autoimmune disease affecting the exocrine glands, most commonly observed in middle-aged women. Childhood pSS is both rare and underdiagnosed, since pediatric patients often do not fulfill the diagnostic criteria applicable to adults. <h3>Objective</h3> To present 7 pediatric cases evaluated for pSS and emphasize the need for childhood-adapted diagnostic criteria. <h3>Methods</h3> All pediatric cases under investigation for pSS referred to our department between January 2018 and December 2019 for oral evaluation and labial minor salivary gland biopsy were reviewed, and the relevant data were analyzed. <h3>Results</h3> Seven of 144 patients with suspected pSS were children (4.86%), and they were aged between 5 and 15 years old. Sicca symptoms and low unstimulated salivary flow rate were present in 1 patient each. Although focal lymphocytic sialadenitis (FLS) was observed in all patients, a focus score of 1/4 mm² was present in 5 of 7 cases, in 1 of which light chain B-cell monoclonality was also noted. Four of these 5 patients were subsequently diagnosed with pSS according to the American College of Rheumatology/European League Against Rheumatism 2016 classification criteria, whereas 1 seropositive patient, 1 with a high focus score, and 1 with recurrent parotid swelling and a positive family history did not meet the above criteria. <h3>Conclusions</h3> Pediatric patients may not fulfill the strict adult criteria for pSS, since destruction of the exocrine glands may not be measurable from the onset. Instead, recurrent parotid gland swelling and presence of any FLS, regardless of the focus score, may serve as alternative criteria in order to avoid underdiagnosis.

Recurrent Parotitis: Extrapulmonary Manifestation of Childhood Tuberculosis

Recurrent parotitis of childhood is a rare condition involving the largest salivary gland. The aetiology is multi-factorial and is usually non-obstructive or non-suppurative type of inflammation. It involves recurrent swelling of the parotid gland unilaterally or bilaterally over a period of months to years. Tuberculosis rarely involves the parotid gland, however in developing countries where tuberculosis prevalence is very high, any child with recurrent parotitis should be investigated for the same. We hereby, describe a 2 and half-year-old female child with recurrent parotid gland swelling below the right ear since 6 months. The swelling was acute in onset, gradually increasing in size with no discharge or pain. There was no history of fever, cough, cold, dryness of mouth or eyes, joint pain or rashes. There was history of koch’s contact in the maternal grandfather. A positive mantoux test and significant cervical lymphandenaopathy on Computed Tomography scan was noted. Common causes of recurrent parotitis, i.e. sjogrens syndrome, immunodeficiency and obstruction were ruled out. On the basis of the above history and investigations, the child was diagnosed as tuberculous parotitis.

Parotid sialometry: A standard technique in the diagnosis of parotid sialadenosis

Abstract Sialadenosis is a clinical condition characterized by bilateral, painless, diffuse and recurrent parotid gland swelling. Histologically, the only feature of note is acinar cell hypertrophy, with no apparent change in the duct structure or cellular infiltrate. The functional changes in the parotid parenchyma in this condition are ill understood. The association between malnutrition and parotid gland swelling was first reported in Egypt. The pathogenesis of the condition remains unclear. The aim of this study is to explain the development of parotomegaly by analysing the parotid secretory pattern in parotomegaly patients Patients with malnutrition were studied at Ain Shams University Hospitals. 47 patients, 19 male patients and 28 female patients, were studied, of these eight patients (three male patients and five female patients) suffered parotomegaly. Thirty-one patients with morbid obesity were recruited. 23 patients were female and eight were male. Six patients in this group had parotomegaly. Results were compared with those of 30 healthy volunteers recruited from medical and nursing staff, medical students and patients attending the ENT clinic for minor procedures. Parotid saliva was collected by the standard technique The results of salivary analysis in 47 patients suggested a pattern of inhibitory proteodyschylia, with increased salivary flow rate and reduced total protein level and amylase activity compared with 30 healthy volunteers. This inhibitory proteodyschylia pattern is identical to the secretory pattern induced experimentally by blocking B-adrenergic receptors in the parotid A possible explanation for the development of parotomegaly in malnutrition is a degenerative neuropathy affecting the B-adrenergic innervation of the parotid that cause acinar cell congestion by zymogen granules, which is manifested clinically as parotomegaly.

Sjögren-Syndrom

Sjögren's syndrome (SS) is a chronic inflammatory disorder of hitherto unknown origin. The characteristic hallmark of SS is focal lymphocytic infiltration and slow destruction of exocrine glands, such as lacrimal and salivary glands. Sicca symptoms and/or recurrent parotid gland swelling are often accompanied by fatigue. Clinically relevant extraglandular manifestations occur in more than 20% of patients with primary SS. The development of malignant B cell lymphoma is the most important complication, which affects about 5% of primary SS patients who are at higher risk to develop malignant B cell lymphoma, both when compared with the general population as well as with patients with SS secondary to other systemic autoimmune disorders. Treatment of sicca symptoms is primarily symptomatic, whereas glucocorticoids, NSAIDs and/or immunosuppressive drugs may be indicated for the treatment of extraglandular manifestations. New therapeutic strategies, such as B cell targeted therapies, are in clinical testing especially for patients with severe organ manifestations.

Recurrent transient parotid gland swelling with clozapine therapy

AbstractWe report a case of recurrent parotid gland swelling in a man receiving clozapine. Our aim is to raise awareness of this iatrogenic condition and to review what is known of its pathogenesis and management.

A Case of Recurrent Swelling of Parotid Gland with Chronic Sialodochitis

A Case of Recurrent Swelling of Parotid Gland with Chronic Sialodochitis

Recurrent swelling of parotid glands and Sjögren's syndrome

This study included 125 patients with chronic parotitis, and it presents, in particular, a long-term clinical, laboratory, and sialographic study of 22 patients who were diagnosed as having adult recurrent sialadenitis of the parotid glands (ARSPG). Twelve of the 22 patients with ARSPG were shown to have Sjogren's syndrome (SS). These patients had recurrent parotid gland swelling for 1.5–14 years (mean, 5.2 years) before xerostomia and keratoconjunctivitis sicca occurred. Ten of the 22 patients with ARSPG did not develop SS, but did experience recurrent parotitis which extended from childhood into adulthood. The ARSPG underwent remission in seven of these patients. It is suggested that patients with ARSPG, but without a history of parotid gland swellings in childhood, should be diagnosed provisionally as having subclinical SS (SCSS).

Bilateral Recurrent Parotid Gland Swelling after Endoscopy

Bilateral recurrent parotid gland swelling after fiberoptic endoscopy is described in a patient who was on carbenoxolone sodium as part of a double blind protocol for gastric ulcers. The possible etiologies for this unusual complication of endoscopy as well as the past literature are reviewed.

Recurrent Swelling of Parotid Gland

Recurrent Swelling of Parotid Gland

Recurrent Swelling of Parotid Gland

Recurrent Swelling of Parotid Gland