Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 4, 2016
Iodide-Induced Sialoadenitis
- Background:
- Iodide induced sialoadenitis is a rare delayed reaction to iodinated contrast manifesting as swelling of the submandibular or parotid glands several hours to several days after administration of iodinated contrast material.
- Clinical Presentation:
- Pathophysiology is thought to be secondary to accumulation of iodide in salivary tissues resulting in edema and ductal dilatation. Therefore, it is not characterized as an anaphylactoid reaction, and premedication with steroids is usually not helpful. The condition may be more frequent in patients with renal dysfunction. There should not be associated angioedema or airway compromise.
- Key Diagnostic Features:
- Symmetric swelling of submandibular or parotid glands after administration of iodinated contrast material.
- CT and MRI show enlarged edematous submandibular or parotid glands with adjacent edema.
- US shows dilated hypoechoic ducts with increased gland vascularity.
- Differential Diagnosis:
- Sjögren syndrome
- Acute or chronic sialidinitis post radiation or I-131 administration
- Treatment:
- The condition is self-limiting, and treatment is supportive.
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