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Heerfordt-Waldenstrom syndrome; uveoparotid fever

Etiology: - may be initial presentation of sarcoidosis [2] Pathology: - parotid gland biopsy (image) no necessary - scattered granulomas with focal central necrosis - stains for acid-fast bacilli & fungi negative - histopathology image (parotid) [3] - compression of facial nerve results in facial nerve palsy Clinical manifestations: - anterior uveitis - parotiditis - fever - with or without facial nerve palsy - can result in sicca symptoms [1] - images [3] Special laboratory: - tissue biopsy not indicated Radiology: - chest radiograph - bilateral hilar adenopathy - paratracheal adenopathy may be noted - CT of the head Differential diagnosis: - Sjogren syndrome Management: - glucocorticoid - prednisone 60 mg QD (case report) [3] - enlargement with uniform contrast enhancement of parotids

General

syndrome

References

  1. Medical Knowledge Self Assessment Program (MKSAP) 17, 18, 19. American College of Physicians, Philadelphia 2015, 2018, 2022.
  2. Denny MC, Fotino AD. The Heerfordt-Waldenstrom syndrome as an initial presentation of sarcoidosis. Proc (Bayl Univ Med Cent). 2013 Oct;26(4):390-2. PMID: 24082416 Free PMC Article
  3. Dua A, Manadan A (images) Images in Clinical Medicine. Heerfordt's Syndrome, or Uveoparotid Fever. N Engl J Med 2013; 369:458. August 1, 2013 PMID: 23902485 Free full text http://www.nejm.org/doi/full/10.1056/NEJMicm1303454
  4. Weerakkody Y, Gaillard F Heerfordt syndrome http://radiopaedia.org/articles/heerfordt-syndrome