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Wegener's granuloma – presenting as a unilateral parotid swelling

  • R. Benson-Mitchell (a1), N. Tolley (a1), C. B. Croft (a1) and D. Roberts (a1)

Abstract

Wegener's granuloma is a systemic necrotizing vasculitis which predominantly affects the upper and lower respiratory tracts and kidneys. The nose and paranasal sinuses are often the first or main sites to be affected. Equally ear involvement is common and a recognized early manifestation of the disease. Salivary gland involvement is rare and is usually part of more widespread systemic involvement.

We present a 34-year-old female with a six-week history of hearing loss and a unilateral parotid swelling. One year previously she was diagnosed as having myalgic encephalomyelitis following a long period of post-viral malaise. The case points to the difficulties encountered when Wegener's granuloma presents in an unusual and varied way. A high index of suspicion coupled with early diagnosis and treatment is essential. The patient made a good recovery.

Copyright

Corresponding author

Mr R. Benson-Mitchell, ENT Department, Southend General Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY.

References

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Abraham-Inpijn, L. (1980) Wegener's granulomatosis, serous otitis media and sinusitis. Journal of Laryngology and Otology 94: 785788.
D'Cruz, D. P., Baguley, E., Asherson, R. A., Hughes, G. R. V. (1989) Ear, nose and throat symptoms in subacute Wegener's granulomatosis. British Medical Journal 299: 419422.
Fauci, A. S., Haynes, B. E., Katz, P., Wolff, S. M. (1983) Wegener's granulomatosis: prospective clinical and therapeutic experience with 85 patients for 21 years. Annals of Internal Medicine 98: 7685.
Murty, G. E. (1989) Wegener's granulomatosis: otorhinolaryngological manifestations. Clinical Otolaryngology 15: 385393.
Nicklasson, B., Stangeland, N. (1982) Wegener's granulomatosis presenting as otitis media. Journal of Laryngology and Otology 96: 277280.
Ridley, M. G., Wolfe, C. S., Asherson, R. A., Hughes, G. R. V. (1988) Recurrent otitis media and pulmonary infiltrates as presenting features in Wegener's granulomatosis. British Medical Journal 297: 352–253.
Small, P., Black, M., Davidman, M., Champlain, M. L. B., Kapusta, M. A., Kreisman, H. (1980) Wegener's granulomatosis and relapsing polychondritis. A case report. Journal of Rheumatology 7: 915918.

Keywords

Wegener's granuloma – presenting as a unilateral parotid swelling

  • R. Benson-Mitchell (a1), N. Tolley (a1), C. B. Croft (a1) and D. Roberts (a1)

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