Zhang Guilian, Li Tao, Wang Heying, Liu Jiao
Department of Neurology, the Second Affiliated Hospital, Medical School of Xi'an Jiaotong University, Xi'an, PR China.
Medicine (Baltimore). 2017 Nov;96(47):e8881. doi: 10.1097/MD.0000000000008881.
Iodide mumps is an uncommon condition, induced by iodide-containing contrast, and is characterized by a rapid, painless enlargement of the bilateral or unilateral salivary gland. At present, the pathogenesis of iodide mumps is not yet clear. It may be related to an idiosyncratic reaction, a toxic accumulation of iodine in the gland duct, or renal function damage leading to an iodine excretion disorder. This paper reports the clinical manifestations and magnetic resonance imaging results of one case of iodide mumps, which occurred after digital subtraction angiography.
A 66-year-old Chinese man presented to our department with a 1-month speech barrier and 1 day of vomiting. He had the history of high blood sugar, the history of high blood pressure and the history of Vitiligo. He had no history of allergies and had never previously received iodide-containing contrast. His renal function and other laboratory examinations were normal. During the digital subtraction angiography (DSA), the patient received approximately 130 mL of nonionic contrast agent (iodixanol). Five hours postsurgery, the patient experienced bilateral parotid enlargement with no other discomfort, such as pain, fever, skin redness, itching, hives, nausea, vomiting, or respiratory abnormalities.
We thought the diagnosis was iodide mumps.
Intravenous dexamethasone (5 mg) was administered.
20 hours post-DSA, after which the bilateral parotid shrunk. By 4 days postsurgery, the patient's bilateral parotid had recovered completely.
We found no obvious abnormal sequence signal in diffusion magnetic resonance imaging or the corresponding apparent diffusion coefficient. Our findings suggest that vasogenic edema may play an important role in the pathogenesis of iodide mumps.
碘化物性腮腺炎是一种罕见病症,由含碘造影剂诱发,其特征为双侧或单侧唾液腺迅速无痛性肿大。目前,碘化物性腮腺炎的发病机制尚不清楚。它可能与特异反应、碘在腺管中的毒性蓄积或导致碘排泄障碍的肾功能损害有关。本文报告1例数字减影血管造影术后发生的碘化物性腮腺炎的临床表现及磁共振成像结果。
一名66岁中国男性因言语障碍1个月及呕吐1天就诊于我科。他有高血糖病史、高血压病史及白癜风病史。他无过敏史,既往从未接受过含碘造影剂。其肾功能及其他实验室检查均正常。在数字减影血管造影(DSA)过程中,患者接受了约130 mL非离子型造影剂(碘克沙醇)。术后5小时,患者出现双侧腮腺肿大,无其他不适,如疼痛、发热、皮肤发红、瘙痒、荨麻疹、恶心、呕吐或呼吸异常。
我们认为诊断为碘化物性腮腺炎。
静脉注射地塞米松(5 mg)。
DSA术后20小时,双侧腮腺缩小。术后4天,患者双侧腮腺完全恢复。
我们在扩散磁共振成像或相应的表观扩散系数中未发现明显异常序列信号。我们的研究结果表明血管源性水肿可能在碘化物性腮腺炎的发病机制中起重要作用。