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%.
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