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bilateral parotid enlargement

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Causes of bilateral parotid enlargement include:

  • local disease:
    • mumps - more commonly children than adults
    • parotitis
    • uveoparotid fever
    • sialectasis - especially if related to eating
    • Sjogren's syndrome
    • tumour infiltration

  • systemic disease:
    • sarcoidosis
    • tuberculosis
    • alcoholism
    • myxoedema
    • Cushing's disease
    • diabetes/insulin resistance - about 25% of patients with overt or latent diabetes have bilateral asymptomatic enlargement of the parotid glands (1)
    • liver cirrhosis
    • gout
    • bulimia nervosa
    • HIV in children may cause bilateral parotid enlargement (2)

  • drugs:
    • thiouracil
    • isoprenaline
    • phenylbutazone
    • high oestrogen contraceptive pills

Bilateral parotid enlargement may also be seen in:

  • severe dehydration
  • malnutrition

Notes:

  • there have been case reports of involvement of the exocrine glands in cases of leukaemia (3)

Reference:

  1. Pulse (2004), 64 (10), 80.
  2. Hoare S. HIV infection in children--impact upon ENT doctors. Int J Pediatr Otorhinolaryngol. 2003 Dec;67 Suppl 1:S85-90.
  3. Obama K et al. Adult T-cell leukemia predominantly involving exocrine glands. Eur J Haematol. 2004 Nov;73(5):332-9.

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