Heerfordt-Waldenström syndrome is a rare subacute variant of sarcoidosis, characterized by enlargement of the parotid or salivary glands, facial nerve paralysis. Images in Clinical Medicine from The New England Journal of Medicine — Heerfordt’s Syndrome, or Uveoparotid Fever. Heerfordt’s syndrome is a rare manifestation of sarcoidosis characterized by the presence of facial nerve palsy, parotid gland enlargement.
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Received Sep 30; Accepted Jul She had been previously diagnosed with uveitis and bilateral hilar lymphadenopathy. Physical examination revealed a swollen right eyelid and right parotid gland.
A year-old nonsmoking African American woman presented with a 3-day history of progressively worsening left facial droop, difficulty swallowing, and blurred vision. Support Center Support Center. A biopsy specimen from his eyelid revealed granulomatous blepharitis, and a granulomatous disease such as sarcoidosis was suspected.
Thank you for updating your details. She was unable to close her left eyelid completely. J Natl Med Assoc.
Tender, mobile submandibular and cervical lymph nodes were palpable bilaterally, but more prominently on the left. No rashes were noted. Typical clinical findings include cough, dyspnea, chest pain, fever, weight loss, arthralgias, and erythema nodosum.
Proc Bayl Univ Med Cent. Heerforrt Cases Courses Quiz. The simultaneous presence of all symptoms represents the complete form of this syndrome, with the complete form constituting 0. Indexed in Web of Science. No nodules were detected and diffuse swelling ysndrome parotid gland was observed in the US examination.
Views Read Edit View history. Synonyms or Alternate Spellings: Some observations of uveoparotitis and allied conditions with special reference to the symptoms from the nervous system. He presented with a regular general status.
Diagnosis of the syndrome is clinical, and treatment depends on the degree of systemic impairment. In patients that have already been diagnosed with sarcoidosis, Heerfordt syndrome can be inferred from the major symptoms of the syndrome, which include parotitisfever, and facial nerve palsy. Adams and Victor’s Principles of Neurology.
Loading Stack – 0 heerforrdt remaining. As uveitis and BHL had been previously diagnosed, she underwent a detailed examination for sarcoidosis in the Department of Respiratory Medicine in our hospital.
A year-old female patient reported having right peripheral facial paralysis, eyndrome no apparent cause. Cranial nerve palsy in neurosarcoidosis may be caused by nerve granulomas, perineural inflammatory infiltrates, increased cranial pressure, or granulomatous basal meningitis [ 1112 ].
Corticosteroid treatment in pulmonary sarcoidosis: Sarcoidosis is a granulomatous disease of unclear etiology, which commonly presents with cough, dyspnea, chest pain, fever, weight loss, arthralgias, and erythema nodosum.
Although uveitis was not detected in the ophthalmologic examination, biopsy specimens heerfordtt the right eyelid and the lymph node in the left thigh revealed noncaseating epithelioid cell granuloma and a diagnosis of sarcoidosis was made histologically Figure 3.
CT of the neck soft tissues demonstrated enlarged lymph nodes, the largest of which measured 3. No bacteria or viruses were grown on culture of the biopsied lymph node. Preauricular lymph node biopsy showing a noncaseating granuloma.
The Heerfordt-Waldenström syndrome as an initial presentation of sarcoidosis
It is normally self-limiting, with cure achieved between 12 and 36 months, but some prolonged cases have been reported. Presence of multinucleated cells in the granuloma right photo, hematoxylin and eosin, X Find articles by Rafael Cavanellas Fraga. Support Center Support Center. A biopsy of the facial lesion was performed, and the histopathology results revealed sarcoid granulomas on the dermis Figure 3. Fine-needle aspiration of a left preauricular lymph node revealed multinucleated giant cells and noncaseating granulomas hedrfordt with granulomatous lymphangitis Figure 2.
Serum angiotensin-converting enzyme ACE levels were twice the upper limit of normal.
The likelihood of permanent paralysis increases in patients who are not treated with corticosteroids. National Center for Biotechnology InformationU. One year later, left peripheral facial paralysis was diagnosed, and the previous treatment was successfully instituted.
This page was last edited on 9 Julyat Monocyte- and macrophage-related cutaneous conditions Autoimmune diseases Syndromes affecting the eyes Facial nerve disorders Syndromes affecting the nervous system. Possible associated diseases need independent treatment 3.