Bilateral parotid gland involvement in Wegener granulomatosis

A K Saha¹, S Rachapalli², S Steer², P Gordon²

¹ Guy’s and St Thomas’ NHS Foundation Trust, Department of Rheumatology, London, UK
² Department of Rheumatology, King’s College Hospital NHS Foundation Trust, London, UK

Correspondence to:
Dr A Saha, Department of Rheumatology, Third Floor, Lambeth Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK; amitsaha55@hotmail.com

Accepted 29 September 2008

The first 150 words of the full text of this article appear below.

Wegener granulomatosis (WG) is a disease characterised by granulomatous inflammation and a vasculitis predominantly affecting small vessels.¹ We describe a patient with WG who presented with bilateral parotid gland involvement, which is particularly unusual.

An 18-year-old woman with asthma presented with symptoms consistent with sinusitis with bilateral parotid gland swelling. She was treated with antibiotics over a 4-week period. Her symptoms failed to improve and she developed an enlarged lacrimal gland 2 months later, associated with 10 kg weight loss and lower limb arthralgia. Her C-reactive protein was 187 mg/l (normal <5 mg/l) and her erythrocyte sedimentation rate was 56 mm/h (normal 1–10 mm/h). A biopsy of the left parotid gland showed poorly formed granulomas. A day after the biopsy, she developed a seventh nerve palsy on the opposite side. After 2 weeks the right parotid gland was biopsied, showing similar histological findings. A presumptive diagnosis of sarcoidosis was made . . . [Full text of this article]

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