Adaptive parotid gland hypertrophy induced by dietary treatment of GSE in rats.

In a 13-week feeding toxicity study of grape skin extract (GSE) performed previously, 5.0% GSE showed diffuse hypertrophy and basophilia in rat parotid glands. To clarify whether the change in the parotid glands was an adverse effect of GSE, 6-week-old male F344 rats were fed a diet containing 5.0% GSE or were administered a dose corresponding to the dietary concentration via gavage for 4 weeks, and the treatment was stopped for 2 weeks. To ascertain the effect of astringency, other animals were fed a diet containing 5.0% tannic acid (TA) using the same protocol as the GSE feed group. Control groups were fed a basal diet or were administered sterilized distilled water by gavage. In the GSE and TA feed groups, diffuse severe hypertrophy and basophilia in the parotid glandular epithelial cells were observed. Macroscopic, microscopic, and ultrastructural characteristics consistent with cellular hypertrophy was less apparent after the recovery period in both feed groups. In contrast, no changes were observed in the parotid glands of the gavage GSE and control groups at week 4. Based on these findings of parotid hypertrophy without cytotoxicity, the data from this and previous studies suggest that hypertrophy of the parotid glands induced by feeding treatment with GSE is an adaptive non-adverse effect that is reversible upon removal of the sialotrophic agent.

Surgical management of bilateral parotid lipomatosis in a patient with HIV.

BACKGROUND: The long-term use of highly active antiretroviral therapy (HAART) in patients with human immunodeficiency virus (HIV) has led to sequelae including lipodystrophy syndrome (LDS). We present the first published case of surgical management of bilateral parotid lipomatosis in a patient with HIV on long-term HAART. METHODS: We undertook review of the case notes from the time of diagnosis with HIV and literature review of this topic. RESULTS: A 45-year-old man with HIV on HAART presented with a 4-year history of increasing bilateral facial swelling. He was asymptomatic apart from the stigmatizing cosmetic deformity. MRI revealed the parotid glands had been replaced by fat. He elected for surgery and parotid lipomatosis was diagnosed on histopathological examination. CONCLUSION: Lipohypertrophy in LDS is rare in the literature and this presentation of bilateral parotid lipomatosis secondary to HAART is only the third reported case, and the first to undergo surgical resection.

Parotid gland swelling following mouthrinse use.

BACKGROUND: Unilateral or bilateral swelling of the parotid gland is a reported side effect of rinsing the mouth with chlorhexidine. Although the incidence rate is extremely low, there have been several case reports on this topic and the authors of these reports have suggested several explanations for the mechanism of this complication. METHODS: In this report, two cases of parotid gland swelling are discussed. Both patients developed unilateral parotid swelling following the use of a mouthwash, case 1 after using a chlorhexidine mouthwash following flap surgery and case 2 after using a hexetidine mouthwash in an approved clinical trial that was testing different mouthwashes. RESULTS: In both of the cases, differential diagnoses were made to explain the cause of the parotid swelling. However, discontinuing use of the product resulted in an eventual complete resolution of symptoms in both patients. CONCLUSIONS: Swelling of the parotid gland following use of a mouthwash has previously been reported, although previous reports found this side effect only in patients who used chlorhexidine mouthwashes. This complication has therefore been informally linked to chlorhexidine. The present case report questions this hypothesis and suggests that parotid gland swelling may not be related to the type of mouthwash used, but may instead be a consequence of the rinsing action itself.

[Mumps in a 80-year-old patient?]. / 80-jährige Patientin mit Mumps?

Iodide mumps is a bilateral swelling of the parotid glands which appears 1-2 days after the administration of iodated contrast material. It is caused by an iodide induced sialadenitis of parotid, submandibular or sublingual glands. The symptoms disappear spontaneously within one week is a rare complication Peripheral facial palsy. Therapeutic options are steroids or antihistamines, especially when there is an accompanying cutaneous vasculitis. This isn't a dangerous disease, but if diagnosed is made, unneccessary diagnostic investigations can be avoided.

Drug-induced paraparotid fat deposition in patients with HIV: case reports.

BACKGROUND: The treatment of patients with HIV is managed effectively with highly active antiretroviral therapy, but complications in the form of a lipodystrophy syndrome (LDS) often develop. CASE DESCRIPTION: . The authors describe two patients who had bilateral parotid area fatty swellings, which are a manifestation of the fat redistribution seen in LDS. Fat hypertrophy, fat atrophy or both in other regions; dyslipidemia; and glucose abnormalities also were present. CONCLUSION AND CLINICAL IMPLICATIONS: Although the LDS in patients with HIV is recognized visibly by fat redistribution, the syndrome includes dyslipidemia and insulin resistance. Dental visits give dentists the opportunity to recognize HIV-related cervicofacial fat alterations. For appropriate attention, referral to the patient's physician who is managing the HIV is indicated.

Induction of salivary polypeptides associated with parotid hypertrophy by gallotannins administered topically into the mouse mouth.

Isoproterenol-induced salivary polypeptides (IISP), a group of proline-rich proteins synthesized by mouse parotids, have been considered as markers for isoproterenol-induced parotid hypertrophy. Rodents fed diets containing high-tannin cereals (sorghum), also develop parotid hypertrophy. To test whether tannins are directly involved in provoking sialotrophic growth, we studied the effect of intraperitoneal and topical oral administrations of tannic acid (TA) on the induction of IISP polypeptides in endogamic mice (A/Snell). TA was characterized by HPLC chromatography and spectral analysis and shown to be composed solely of gallotannins, a complex family of glucose and gallic acid esters. IISP polypeptides were monitored in saliva by SDS-polyacrylamide gel electrophoresis during 36 h after ending TA stimulation. Single daily intraperitoneal administrations of TA for 3 consecutive days (0.033 mg/g bw/day), at variance of parallel administrations of isoproterenol (0.042 mg/g bw/day) failed to induce IISP polypeptides. However, repeated topical applications of TA into the mouse mouths (1.21 mg/g bw divided into three equal doses given at 4-h intervals within a single day) resulted in unequivocal induction of IISP polypeptides. That response was clearly intensified by increasing the stimulation frequency to eight equivalent doses given at 1.5-h intervals within a single day (corresponding to 3.23 mg/g bw) and even further by repeating this protocol for 3 days. Under these productive schemes of stimulations by TA, electrophoretic fractionation of parotid homogenates showed new polypeptide bands migrating in parallel to salivary IISP. These results suggest that topically administered gallotannins are effective inducers of trophic growth in mouse parotids.

Valproic acid-associated sialadenosis of the parotid and submandibular glands: diagnostic and therapeutic aspects.

Sialadenosis has been defined as a non-inflammatory, parenchymatous salivary gland disease causing recurrent, bilateral swelling of the salivary glands. As an adverse drug reaction of valproic acid, sialadenosis is very rare. To our knowledge, it has been reported only once in the world literature to date. We present herein the case of a patient with valproic acid-associated sialadenosis of both the parotid and submandibular glands. This appears to be the first published case of a patient who received surgical treatment. On light and electron microscopy of all the affected salivary glands, granular sialadenosis with predominantly moderate electron-dense secretory cytoplasmatic granules was observed. No relevant degenerative alterations were seen. There was no histological evidence of peripheral neuropathy of the nerve supply, leading to disordered activity of acinar cells by loss of neurosecretory granules. Lateral parotidectomy, performed under neuromonitoring control for safety reasons, is the treatment of choice for chronic recurrent parotitis that does not respond to conservative therapy, particularly if the cosmetic deformity is unacceptable to the patient. If the submandibular glands are involved, partial removal is recommended.

Captopril-induced bilateral parotid and submandibular sialadenitis.

Two cases of sialadenitis following treatment with captopril are described. In case 1, an upper chest and facial erythema and dryness of the mouth accompanied the swelling of the salivary glands. In case 2, a conjunctival erythema accompanied the sialadenitis. None of the patients had previously used captopril, and, in both cases, the swelling occurred within the first hour after the drug intake; the patients had a complete recovery within a few hours after captopril was withdrawn. It is possible that the reported effect was caused by a type-B idiosyncratic adverse drug reaction.

[Parotid tuberculosis following intravesical BCG instillation: a case report]. / Tuberculosis parotídea secundaria a instilación vesical con BCG: a propósito de un caso.

First case of parotid gland tuberculosis publicated to date is presented after intravesical instillation of BCG for a superficial bladder cancer. The diagnosis of the parotid gland tuberculosis is difficult because it is usually indistinguishable from a neoplasm. Combined fine-needle aspiration cytology with PCR or LCR amplification of mycobacterial DNA could be a good diagnostic tool avoiding an open biopsy.

[Bilateral parotid gland swelling with hyperamylasemia following cesarean section under regional anesthesia--report of two cases].

Bilateral parotid gland swelling with hyperamylasemia occurred in two patients on the first postoperative day after cesarean section under combined epidural-spinal anesthesia. Total ephedrine doses used to treat hypotension due to anesthesia were 48 and 52 mg, respectively. These symptoms and findings seemed to have been caused by beta stimulating effect of high dose ephedrine.