Chronisch rezidivierende Parotitis des Kindesalters bei eineiigen Zwillingen Magnetresonanzsialographie

Abstract

Recurrent parotitis is rare in childhood. Its occurrence is characterized by recurrent episodes of swelling and pain in the parotid gland, which are usually accompanied by fever and malaise. Inflammation usually resolves spontaneously during adolescence. The disorder is a condition of unknown etiology. Sialectasis and stricturing occurs in the distal ducts, whereas inflammation of the gland and duct epithelium is probably caused by a low salivary flow rate. Which one can be considered the primary event or secondary change remains unknown. The main-stay of diagnosis is sialography, which depicts typical intraparotidal duct system lesions as strictures or ectasias and excludes sialolithiasis. We here report two 10-year-old male monovular twins who suffered from recurrent swelling and pain in only their left parotid glands. Symptoms were noted approximately every 6 weeks in both patients strictly. Characteristic sialectasis of the distal ducts was demonstrated by magnetic resonance-sialography. Our findings support the hypothesis that recurrent parotitis is caused by a congenital abnormality of the salivary gland ducts. Diagnostic imaging was performed by magnetic resonance imaging during the acute phase of the disease. This technique helps to make the diagnosis without retrograde application of a contrast agent.

Salivary gland diseases in children

“…Familial disease, in the sense of an autosomal dominant inheritance, has frequently been reported in the literature [ 18 ]. Wittekindt et al published a case report relating to this, which involved identical twins with chronic recurrent parotitis in childhood [ 130 ]. Reid et al reported a family where four members had the disease and two others had asymptomatic changes [ 131 ].…”

“…MRI and MR sialography are excellent ways of visualising salivary gland parenchyma as well as the excretory ducts. The latter can be seen without contrast enhancement in a special T2 weighting [ 130 ]. With alternative methods available, however, the time and effort required for this type of imaging in children mean that it is only worth considering for paedriatric patients in exceptional cases.…”

Klinische Aspekte der abszedierenden Parotitis

“…Dies wurde auch in der Literatur bereits in Einzelfällen beschrieben [13]. Neuere Studien konnten durch Sialographie oder Magnetresonanzsialographie die Hypothese stützen, dass dieses Krankheitsbild vor allem auf kongenitalen Abnormitäten des Gangsystems beruht [21]. Neuere Studien konnten durch Sialographie oder Magnetresonanzsialographie die Hypothese stützen, dass dieses Krankheitsbild vor allem auf kongenitalen Abnormitäten des Gangsystems beruht [21].…”