Sjögren’s syndrome should be considered in patients with recurrent parotitis

Baszis K. Pediatrics. 2012;129:e179-e182.

Recurrent parotitis should trigger clinicians to consider pediatric Sjögren’s syndrome, according to a case report published online recently.

Kevin Baszis, MD, of Washington University School of Medicines’ pediatric rheumatology department, and colleagues reported on four patients with recurrent parotitis, which was diagnosed as an early manifestation as Sjögren’s syndrome. “Although infection, recurrent juvenile parotitis and anatomic abnormalities are more common etiologies, primary pediatric [Sjögren’s syndrome] should be considered when encountering a patient with recurrent parotitis,” they said.

According to the researchers, this etiology should be considered after other more common etiologies such as juvenile recurrent parotitis, anatomic abnormalities and infection are excluded as causes. Typically, “affected children are febrile and develop painful swelling of one or both parotids every 3 to 4 months. It most often manifests between 3 and 6 years of age and is more common in boys,” they said.

In their population of patients, the researchers wrote, “Despite lack of ocular complaints, three of these patients had ocular findings on ophthalmologic exam,” adding that their patients’ laboratory results were similar to other presentations, including “presence of rheumatoid factor and hypergammaglobulinemia.”

Although treatment regimens vary, the researchers said all four of their patients received hydroxychloroquine. Through follow-up, none of the children developed features of other autoimmune illnesses.

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