“…Recurrent parotitis has also been associated with hypogammaglobulinemia, isolated immunoglobulin G 3 deficiency, and immunoglobulin A deficiency, as was seen in one patient in our study . High concentrations of Streptococcus pneumonia and Haemophilus influenza have been isolated in the saliva of patients with JRP …”
“…Recurrent parotitis has also been associated with hypogammaglobulinemia, isolated immunoglobulin G 3 deficiency, and immunoglobulin A deficiency, as was seen in one patient in our study . High concentrations of Streptococcus pneumonia and Haemophilus influenza have been isolated in the saliva of patients with JRP …”
“…Heerfordt syndrome is defined as a triad of uveitis, facial nerve palsy and parotid enlargement in patients with sarcoidosis. 24,28 Figure 11.Sarcoidosis. (a) Axial T2-weighted image shows well-defined hyperintense focal lesions (arrows) in both parotid glands more on the left side.…”
Section: Granulomatous Sialadenitismentioning
confidence: 99%
“…Salivary gland involvement typically occurs early in the course of the disease and may be seen in limited forms of the disease. 20–31…”
Sialadenitis is an inflammation or infection of the salivary glands that may affect the parotid, submandibular and small salivary glands. Imaging findings vary among unilateral or bilateral salivary gland enlargement, atrophy, abscess, ductal dilation, cysts, stones and calcification. Imaging can detect abscess in acute bacterial suppurative sialadenitis, ductal changes with cysts in chronic adult and juvenile recurrent parotitis. Imaging is sensitive for detection of salivary stones and stricture in obstructive sialadenitis. Immunoglobulin G4-sialadenitis appears as bilateral submandibular gland enlargement. Imaging is helpful in staging and surveillance of patients with Sjögren's syndrome. Correlation of imaging findings with clinical presentation can aid diagnosis of granulomatous sialadenitis. Post-treatment sialadenitis can occur after radiotherapy, radioactive iodine or surgery.
“…8 The etiology is largely unknown, although there is evidence to suggest it may be immunologically mediated as it has been associated with hypogammaglobinemia, immunoglobulin A deficiency, isolated immunoglobulin G3 deficiency, and HLA-B27 seropositivity. [9][10][11][12][13][14][15][16] Parotid inflammation by these mechanisms is thought to promote salivary stasis, and chronic inflammation can compromise salivary ductal vascular supply. 17 The true incidence of JRP is unknown as there is no standardized diagnostic test and most cases in the literature are case reports.…”
Introduction: Recurrent salivary gland swelling of the parotid and submandibular glands results in painful swelling in the pediatric population. There is no defined algorithm for workup and treatment of these disorders, resulting in wide heterogeneity and in some cases overuse of computed tomography (CT) imaging. Sialendoscopy (SE) is an interventional option for recurrent swelling of both glands; however, its effectiveness in the pediatric population is still being determined. Objectives: To assess preoperative imaging utilization and benefit in the workup of recurrent pediatric sialadenitis, intraoperative SE findings, and postoperative outcomes after intervention with SE. Methods: Case-series with a 5-year retrospective chart review on children undergoing SE for recurrent sialadenitis. Results: Forty-nine SE procedures were performed on 38 parotid glands (PG) and 11 submandibular glands (SMGs) in 29 children. CT imaging findings were useful for identifying a stone or stricture and guiding surgical management in 45.5% of SMGs versus 2.6% of PGs ( P < .001). A stone was found in 45.5% of SMGs and none in PG ( P < .001). SE intervention such as balloon dilation or stone removal was performed in 54.6% of SMGs and 5.3% of PGs ( P < .001). 74% of parotid patients undergoing SE responded to 1 intervention with a cessation of recurrent gland swelling, while 26% required additional interventions. One hundred percent of SMG patients responded to first intervention. There was no improvement in the beneficial effect of SE with steroid injection ( P = .897) regardless of steroid used ( P = .082). Conclusion: CT findings were found to be low yield for recurrent parotid swelling, and ultrasound is a recommended first-line step for PG pathology. SE is a recommended first-line intervention for SMG and parotid sialadenitis as demonstrated by 100% and 74% response rate to initial SE, respectively.
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