Two Cases of Heerfordt’s Syndrome: A Rare Manifestation of Sarcoidosis

Abstract

Heerfordt's syndrome is a rare manifestation of sarcoidosis characterized by the presence of facial nerve palsy, parotid gland enlargement, anterior uveitis, and low grade fever. Two cases of Heerfordt's syndrome and a literature review are presented. Case 1. A 53-year-old man presented with swelling of his right eyelid, right facial nerve palsy, and swelling of his right parotid gland. A biopsy specimen from the swollen eyelid indicated sarcoidosis and he was diagnosed with incomplete Heerfordt's syndrome based on the absence of uveitis. His symptoms were improved by corticosteroid therapy. Case 2. A 55-year-old woman presented with left facial nerve palsy, bilateral hearing loss, and swelling of her bilateral parotid glands. She had been previously diagnosed with uveitis and bilateral hilar lymphadenopathy. Although no histological confirmation was performed, she was diagnosed with complete Heerfordt's syndrome on the basis of her clinical symptoms. Swelling of the bilateral parotid glands and left facial nerve palsy were improved immediately by corticosteroid therapy. Sarcoidosis is a relatively uncommon disease for the otolaryngologist. However, the otolaryngologist may encounter Heerfordt's syndrome as this syndrome presents with facial nerve palsy and swelling of the parotid gland. Therefore, we otolaryngologists should diagnose and treat Heerfordt's syndrome appropriately in cooperation with pneumologists and ophthalmologists.

Heerfordt's Syndrome Associated with Trigeminal Nerve Palsy and Reversed Halo Sign

“…The standard treatment strategy for Heerfordt's syndrome has not been established because of the rarity of this syndrome. However, corticosteroid treatment based on the neurosarcoidosis should be applied for cases in which facial nerve palsy is frequently observed ( 24 ). The majority of Heerfordt's syndrome cases, including our own, have responded to corticosteroid therapy ( Table1-2 ).…”

Heerfordt-Waldenström Syndrome Manifesting as Cardiac Sarcoidosis

“…The diagnosis of Heerfordt-Waldenström syndrome is made by the clinical presentation along with a lymph node biopsy revealing non-caseating granulomas. When all symptoms are present, it is considered the complete type; when two of three symptoms occur (facial nerve palsy, enlarged parotid glands, anterior uveitis), it is considered incomplete type [ 7 ].…”

Heerfordt’s syndrome: an uncommon manifestation of sarcoidosis

“…It usually affects the lungs but any organ maybe involved. 1 Heerfordt's syndrome is described as a part of spectrum of sarcoidosis occurring in approximately 0.3% of sarcoidosis cases. 2 It presents with fever, uveitis and bilateral parotid gland swelling with unilateral or bilateral facial nerve palsy.…”