Heerfordt's syndrome

Heerfordt's syndrome
Classification and external resources
DiseasesDB 33567
MeSH D014608

Heerfordt's syndrome, also referred to as uveoparotid fever,[1] Heerfordt–Mylius syndrome, Heerfordt–Waldenström syndrome, and Waldenström’s uveoparotitis,[2] is a rare manifestation of sarcoidosis. The symptoms include inflammation of the eye (uveitis), swelling of the parotid gland, chronic fever, and in some cases, palsy of the facial nerves.[1]

History

The condition was first described in 1909 by Danish ophthalmologist Christian Frederick Heerfordt, for whom the syndrome is now named.[3] It was originally attributed to mumps, but after further studies by Swedish doctor Jan G. Waldenström in 1937, it was classified as a distinct manifestation of sarcoidosis.[2][4]

Causes

The exact cause of Heerfordt's syndrome has not yet been definitively determined. Of those patients who have been diagnosed with Heerfordt's syndrome, 15% have a close relative who also has the syndrome. One possible explanation is that the syndrome results from a combination of an environmental agent and a hereditary predisposition. Mycobacterium and Propionibacteria species have both been suggested as the environmental agent, though the evidence for this is inconclusive.[1]

Prevalence

In the United States, sarcoidosis has a prevalence of approximately 10 cases per 100,000 whites and 36 cases per 100,000 blacks.[5] Heerfordt's syndrome is present in 4.1–5.6% of those with sarcoidosis.[6]

Diagnosis and treatment

In patients that have already been diagnosed with sarcoidosis, Heerfordt's syndrome can be inferred from the major symptoms of the syndrome, which include parotitis, fever, and facial nerve palsy. In cases of parotitis, ultrasound-guided biopsy is used to exclude the possibility of lymphoma.[7] There are many possible causes of facial nerve palsy, including Lyme disease, HIV, Melkersson–Rosenthal syndrome, schwannoma, and Bell's palsy. Heerfordt's syndrome exhibits spontaneous remission. Treatments for sarcoidosis include corticosteroids and immunosuppressive drugs.[1]

See also

Notes

References

  1. 1 2 3 4 Evanchan, Jason; Barreiro, Timothy J.; Gemmel, David (May 2010). "Uveitis, salivary gland swelling, and facial nerve palsy in a febrile woman". Journal of the American Academy of Physician Assistants. 23 (5): 46–50. doi:10.1097/01720610-201005000-00012. PMID 20480871.
  2. 1 2 synd/3546 at Who Named It?
  3. ↑ Heerfordt C.F. (1909). "Über eine "Febris uveo-parotidea subchronica" an der Glandula parotis und der Uvea des Auges lokalisiert und häufug mit Paresen cerebrospinaler Nerven kompliziert". Albrecht von Grafes Archiv für Ophthalmologie. 70: 254–273. doi:10.1007/bf02008817.
  4. ↑ Waldenström, J. G. (1937). "Some observations on uveoparotitis and allied conditions with special reference to the symptoms from the nervous system". Acta Medica Scandinavica. 91: 53–68. doi:10.1111/j.0954-6820.1937.tb16029.x.
  5. ↑ Iannuzzi, Michael C.; Rybicki, Benjamin A.; Teirstein, Alvin S. (22 November 2007). "Sarcoidosis". New England Journal of Medicine. 357 (21): 2153–65. doi:10.1056/NEJMra071714. PMID 18032765.
  6. ↑ Fukuhara K, Fukuhara A, et al. (August 2013). "Radiculopathy in patients with Heerfordt's syndrome: two case presentations and review of the literature". Brain and Nerve. 65 (8): 989–92. PMID 23917502.
  7. ↑ Fischer, T.; et al. (January 2002). "Diagnosis of Heerfordt's syndrome by state-of-the-art ultrasound in combination with parotid biopsy: a case report.". European Radiology. 12 (1): 134–7. doi:10.1007/s003300100879. PMID 11868089.

Facial nerve palsy in a young man. Khokhar, Imtiaz A. // Patient Care;10/15/1996, Vol. 30 Issue 16, p160

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