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Disorders of the salivary glands
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
salivary gland, more commonly the parotid - the so called sarcoid pseudotumour. In such circumstances, the diagnosis is only likely to be made following surgical excision for a presumed neoplasm. Heerfordt’s syndrome is sarcoidosis that involves parotid swelling, anterior uveitis, facial palsy and fever.
Sarcoidosis extra-pulmonary manifestations
Published in Muhunthan Thillai, David R Moller, Keith C Meyer, Clinical Handbook of Interstitial Lung Disease, 2017
Dominique Valeyre, Hilario Nunes, Florence Jeny, Matthieu Mahévas, Marc A Judson
Bilateral parotid swelling is seen in less than 5% of patients. This occurs most often at disease onset, and often spontaneously resolves in 8–12 weeks independently of the general course of the disease. Submaxillary and sublingual glands may also be involved. Parotid involvement may be an element of Heerfordt syndrome.
Systemic illnesses (diabetes mellitus, sarcoidosis, alcoholism, and porphyrias)
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Stephanie Kielb, Laurie Bachrach, Nancy Rios
Up to 60% of patients with sarcoidosis are asymptomatic, the disease is usually revealed incidentally on chest radiography during routine screening examination. However, it may present acutely or subacutely in 20%–40% of cases. In those cases, patients can present with fever, fatigue, anorexia, night sweats, malaise, or weight loss for weeks. Although these complains are mostly mild, but in approximately 25% of patients they are striking.48 In more severe cases, respiratory problems and polyarthritis may occur. Lofgren’s syndrome, an acute presentation encompassing arthritis, bilateral hilar adenopathy, and erythema nodosum, is seen in 9%–34% of patients, the majority of these being Scandinavian and Irish females. Heerfordt’s syndrome consists of parotid gland enlargement, uveitis, fever, and unilateral or bilateral cranial nerve palsies, usually of the facial nerve. In 40%–70% patients, pulmonary sarcoidosis can rapidly progress in a matter of months. Significant organ impairment other than in the lungs is seen in 10% of patients. Patients with acute aggressive disease usually evolve to chronic disease with permanent damage of the affected organs.
The pharmacotherapeutics of sarcoidosis
Published in Expert Review of Clinical Pharmacology, 2022
Patrick Mangialardi, Richart Harper, Timothy E Albertson
The presence of specific HRCT or chest radiographic patterns and presence of extrapulmonary sarcoidosis help the clinician in deciding when to initiate therapy. Stage 0 or I chest radiographs in the absence of extrapulmonary sarcoidosis suggest an excellent prognosis with a high likelihood of spontaneous remission. Chest radiographic Stage III imaging is associated with a low likelihood of spontaneous remission and warrants early intervention. This is similarly true for chest radiographic Stage IV disease. Patients with Stage II disease without extrapulmonary sarcoidosis may remit more than 50% of the time, whereas the presence of extrapulmonary sarcoidosis will sway most clinicians to initiate therapy. Specific acute clinical manifestations such as Lofgren’s syndrome or Heerfordt’s syndrome have a predictable clinical course that helps in therapeutic decision-making.
Sarcoidosis: epidemiology, characteristics, and outcomes over 10 years - a single-center study in Pakistan
Published in Expert Review of Respiratory Medicine, 2022
Muhammad Junaid Akram, Usman Khalid, Muhammad Abu Bakar, Faheem Mahmood Butt, Mohammad Bilal Ashraf
Of the total, 178 (80.2%) patients were symptomatic with 115 (51.8%) having multi-organ involvement. At presentation, 91 (41%) patients had only pulmonary symptoms (Single or multiple), of which 60 (27%) had shortness of breath, 20 (9%) had cough while 75 (33.8%) had both cough and shortness of breath. A total of 131 patients reported with extra-pulmonary symptoms; 63(28.4%) reported single while 68(30.6%) reported multiple extra-pulmonary symptoms as shown in Table 2. Additionally, Lofgren’s and Heerfordt syndrome were diagnosed in 8(3.6%) and 3(1.6%) patients, respectively, while 7(3.2%) patients had combined sarcoidosis and tuberculosis.
Clinical features of sarcoidosis patients presenting with head and neck manifestations – a two-center retrospective study and proposal of a diagnostic algorithm for the otorhinolaryngologist
Published in Acta Oto-Laryngologica, 2020
Thorsten Send, Peter Korsten, Mattis Bertlich, Christoph Braunwarth, Friedrich Bootz, Dirk Skowasch, Mark Jakob
Multiple manifestations are possible in the ear-nose-throat (ENT) region, such as lymphadenitis colli (40–50%), facial nerve palsy, acute or chronic sinusitis, ocular involvement (19–21%), swelling of the parotid glands (5%) as part of Heerfordt’s syndrome or xerostomia [4,8]. The clinical findings are often non-specific and must, therefore, be distinguished from other diseases, such as lymphomas, tuberculosis, or metastases originating from other sites [9].