JUVENILE RECURRENT PAROTIDITIS…NOT ALWAYS WHAT IT SEEMS
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v22.i1.12895Keywords:
Hydroxychloroquine, myositis, recurrent parotitis, Sjögren SyndromeAbstract
Introduction: Juvenile recurrent parotiditis (JRP) is a relapsing inflammation of the parotid gland, usually associated with non-obstructive sialectasis. The Sjögren syndrome (SS), rare in children, may present at this age, in the form of recurrent parotiditis.
Case Study: Female, 13 years, in the fourth episode of parotid swelling and pain, begins investigating: ultrasound of the parotid glands revealed heterogeneous texture and multiple punctiforme calcifications, high ANA (1:1280) title, with speckled pattern, auto-antibodies anti-SSA, anti-SSB and Rheumatoid Factor positive, hyper-gamaglobulinemia and elevated Immunoglobulin G. We also observed elevation of Creatinofosfoquinase, Glutamic Oxaloacetic Transaminase and Glutamic Pyruvic Transaminase. A minor salivary gland biopsy was consistent with a diagnosis of SS. Treatment was started with systemic steroids combining hydroxychloroquine during exacerbations, with clinical improvement.
Discussion/conclusion: The age of onset of parotid swelling helps in differentiation between JRP idiopathic and other clinical entities. The muscle involvement occurs in primary SS and has a varied clinical and pathological spectrum, subclinical myositis occurs in a percentage that varies between 5% and 37%.
Downloads
References
Piltcher O. Afecções das glândulas salivares na infância. In:
Sih T, Chinski A, Eavey R, Godinho R. V Manual de otorrinolaringologia
pediátrica da Interamerican Association of
Pediatric Otorhinolaryngology (IAPO). 1.ª Edição. Brasil: Lis
GráÞ ca e Editora;2006:p127 -32.
Gajendra V, Nagabhushana D, Mamatha G, Annigeri R. Bilateral
Parotid Swelling in a child – A case report. Indian Soc
Pedodon Prev Dent 2004; 22:17 -20.
Chitre V, Premchandra J. Recurrent parotitis. Arch Dis Child
;77:359 -63.
Miziara ID, Campelo S. Parotidite recorrente da infância: estudo
em longo prazo de cinco casos e revisão da literatura.
Rev Bras Otorrinolaringol 2005;71:570 -5.
Oliveira W, Assis L, Crosara S, Becker H, Guimarães R,
Oliveira J et al. Síndrome de Sjögren primário em crianças:
relato de caso. Rev Bras Cirurgia da Cabeça e Pescoço
;34:50 -2.
Bricks LF. Parotidite recorrente da infância. Rev Paulista de
Pediatria 2007;25: 190 -2.
Woo P, Laxer M, Sherry D. Juvenile Dermatomyositis. Pediatric
Rheumatology in Clinical Practice. 1st Edition. London:
Springer Editors;2007:66 -76.
Houghton K, Malleson P, Cabral D, Petty R, Tucker L. Primary
Sjögren’s Syndrome in Children and Adolescents:
Are Proposed Diagnostic Criteria Applicable? J Rheumatol
;32:2225 -32.
Muscal E, DeGuzman M, Jung L, Flaitz C. Pediatric Sjogren
Syndrome. Disponível em: http://emedicine.medscape.com/
article/1008536 -overview
Cedalia A. Sjögren Syndrome. In: Kliegman RM, Behrman
RE, Jenson HB, Stanton BF. Nelson Textbook of Pediatrics.
th Edition. Philadelphia: Saunders Editors; 2007:1028 -9.
Tucker LB. Sjögren syndrome In: Cassidy JT. Petty RE, Laxer
RM, Lindsley CB. Textbook of Pediatric Rheumatology. 6th
edition. Philadelphia: Saunders Elsevier; 2011:548 -65.
Panush R, Kramer N, Rosenstein E. Undifferentiated systemic
rheumatic (connective tissue) diseases and overlap
syndromes. Disponível em: http://www.uptodate.com/contents/
undifferentiated -systemic -rheumatic -connective -tissue-
-diseases -and -overlap -syndromes
Cervera R, Khamashta MA, Hughes GR. ‘Overlap’ syndromes.
Ann Rheum Dis 1990; 49:947 -8.
Hara T, Nagata M, Mizuno YU, Matsuo M, Ueda K, Recurrent
parotid swelling in children: clinical features useful for differential
diagnosis of Sjögren’s syndrome. Acta Paediatr 1992;
:547 -9.
Aoki A, Ono S, Ueda A, Hagiwara T, Tsuji T, Misumi M, et al.
Myositis in primary Sjögren’s syndrome: clinical and pathological
report. Mod Rheumatol 2003; 13:57 -61.
Sjögren syndrome. Disponível em: http://www.mdconsult.
com
Venables PJ. Management of patients presenting with Sjögren
syndrome. Best Pract Res Clin Rheumatol 2006;
:791 -807.
Downloads
Published
How to Cite
Issue
Section
License
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.
