Treatment of refractory sarcoidal parotid gland swelling in a previously reported unresponsive case.

BACKGROUND: Sarcoidosis is a multisystem granulomatous disease that is seen occasionally in patients with characteristic bilateral parotid gland swelling. Conventional therapy has involved either no treatment because of spontaneous remission or corticosteroids when organ involvement is severe. CASE DESCRIPTION: The authors describe a previously published case report of a patient with sarcoidosis with parotid gland swellings who did not respond to standard therapy. Despite the use of various immunosuppressive agents, the swellings failed to resolve over a three-year period. It was only after a newly recommended agent, infliximab, was used that the patient's condition was treated successfully. CLINICAL IMPLICATIONS: It is important for dental practitioners to be familiar with manifestations of sarcoidosis, particularly its salivary gland aspects. Inherent in the knowledge of the disease is the therapeutic approach to both routine and recalcitrant

Bilateral parotid swelling caused by sarcoidosis.

BACKGROUND: Sarcoidosis is a multisystem granulomatous disease characteristically causing bilateral hilar lymphadenopathy. Salivary gland swellings also are seen, which mandate recognition by the dental profession. CASE DESCRIPTION: The authors describe a patient whose diagnosis of sarcoidosis was tenuous. Ocular involvement and an elevated serum angiotensin-converting enzyme level suggested a diagnosis of sarcoidosis. Confirmation with a tissue biopsy was achieved only when the clinicians recognized that salivary gland swelling probably represented a manifestation of the disease. Steroid therapy was instituted. CLINICAL IMPLICATIONS: It is important for the dental practitioner to be familiar with the salivary gland manifestation of sarcoidosis. Early recognition and intervention aborts or slows disease progression.