SASPID case of the month
Nicolette du Plessis, Paediatric Infectious Diseases, University of Pretoria
A 9-year old girl was referred for evaluation with a 5-year history of recurrent parotid swelling. The episodes of parotid swelling occur once every 4-5 weeks, is mostly bilateral, and is not associated with fever. She does experience localised pain for 4-5 days. The swelling subsides between “attacks”. She also complains of infrequent, but intermittent cramping in both her hands.
She underwent a laparotomy at 1 year of age for intestinal obstruction (possible intussusception) with bowel resection.
Birth history: Nothing significant
Mom’s antenatal history: Normal
Feeding: Normal family diet
Social history: 7 siblings, rest of the siblings are healthy.
She is a well grown pre-pubertal girl.
She has visible bilateral parotid enlargement. No abnormalities could be visualised at the opening of the parotid ducts and no stones or masses were palpable.
She had no dysmorphic features, no features of neurocutaneous syndromes or other skin changes visible.
The rest of her systemic examination was normal.
Question 1 What would be your differential diagnosis to recurrent chronic parotitis in childhood?
Question 2 - What investigations would you request?
Question 3 - Shortly discuss the condition “recurrent parotitis of childhood”?
Question 4 - What other diagnostic criteria is necessary to diagnose childhood onset Sjögren’s?
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