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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As with other manifestations of sarcoidosis, corticosteroids are the mainstay of treatment. Treatments for sarcoidosis include corticosteroids and immunosuppressive drugs. Treatment with a high-dose steroid improved her parotid gland enlargement, facial palsy, and anterior uveitis.

Do you know this syndrome? Heerfordt-Waldenström syndrome

As a result of consultation with the Department of Respiratory Medicine, treatment with prednisolone was started based on the premise that there was a possibility of a delayed histological confirmation of the diagnosis. Here we present a case of a year-old nonsmoking African American woman who presented with 3 days of progressively worsening left facial droop, difficulty swallowing, and blurred vision.

Author information Copyright and License information Disclaimer. Syndromf manifestations of sarcoidosis in various organs.

Orofacial granulomatosis—a year review. Typical clinical findings include cough, dyspnea, chest pain, fever, weight loss, arthralgias, and erythema nodosum. After three months, the patient developed a cough, chest pain and dyspnea and was admitted for investigation. Diagnosis of Heerfordt’s syndrome by state-of-the-art ultrasound in combination with parotid biopsy: Support Center Support Center.

Check for errors and try again. A year-old woman presented with left facial nerve palsy, heeerfordt hearing loss, and swelling of her bilateral parotid glands. The patient’s ophthalmologic exam was notable for impaired corneal sensation, punctate epithelial erosions in both eyes, syndrime no overt flare or leukocytes seen on slit lamp exam.


Heerfordt syndrome – Wikipedia

In cases of parotitis, ultrasound -guided biopsy is used to exclude the possibility of lymphoma. The condition was first described in by Danish ophthalmologist Christian Frederick Heerfordt, for whom the syndrome is now named. In tuberculosis, the mastoid, middle ear, or petrous bone is often involved 12. Heerfordt syndrome exhibits spontaneous remission.

As he also presented with a 3-month history of swelling of the right parotid gland and a 1-month history of right facial palsy, he was referred to the Department of Otolaryngology. No nodules were detected and diffuse swelling syndro,e parotid gland was observed in the US examination.

Nerve granulomas and vasculitis in sarcoid peripheral neuropathy: Find articles by Priscila Kakizaki. Presence of multinucleated cells in the granuloma right photo, hematoxylin and eosin, X Sarcoidosis D86 The remainder of the neurologic exam was normal.

Two months after discharge, her facial nerve palsy, parotitis, fevers, and uveitis had resolved. Oral corticosteroids represent the first line treatment option. When complete eye closure is not possible, the patient should use artificial tears while awake, use lubricant eye ointment at night, and cover the affected eye during sleep to prevent exposure keratopathy.

National Center for Biotechnology InformationU. Three patients had the full form, 13 had the incomplete form, and all had uveitis. CT of the neck soft tissues demonstrating prominent cervical lymphadenopathy. Angiotensin I-converting enzyme ACE for sarcoidosis hefrfordt.

The Heerfordt-Waldenström syndrome as an initial presentation of sarcoidosis

Physical examination revealed a left facial droop involving the forehead, cheek, and chin with an inability to close the left eyelid. Find articles by Priscilla Fernandes Senise. Serum ACE and sIL-2R levels were elevated; however, there was no significant elevation in serum antibody for varicella zoster virus. View at Google Scholar B. Computed tomography Ysndrome of the chest showed hilar lymphadenopathy with bibasilar interstitial lung disease. Diagnosis of the syndrome is clinical, and treatment depends on the degree of systemic impairment.


The patient was negative bilaterally for stapedial reflex. She had a history of postherpetic neuralgia and purpura pigmentosa chronica. NET showed no severe damage to the facial nerve. Find articles by Neusa Yuriko Sakai Valente. Larissa Karine Leite Portocarrero, Av.

Epidemiology Clinical presentation Radiographic features Treatment and prognosis History and etymology Practical points Related heefrordt References.

Case Reports in Otolaryngology

The diagnosis of HWS is clinical. Pathol Biol Paris ; 53 3: This patient had marked improvement of symptoms after 4 days of prednisone therapy.

The authors declare that there is no conflict of interests regarding the publication of this paper. The presence of these cases implies syndrrome site of the facial nerve lesion is not limited to the parotid gland.

Her posterior pharynx was erythematous, but no areas of oropharyngeal fluctuance were noted. Sundrome these cases, immunosuppressant agents, including azathioprine, methotrexate, cyclosporine A, and cyclophosphamide, are used in combination with the corticosteroids [ 910 ].

Sarcoidosis and its neurological manifestations.