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Peggyj
02-22-2008, 09:58 AM
My parotid glands, those salivary glands right in front of my ears, have been swollen for over 3 months. I was taking 60mg Prednisone every day when this started and my rheumy decided to refer me to an ENT doc for evaluation. The ENT doc doesnít think itís Sjogrens because 1) the antibody tests for Sjogrens are negative and 2) dry eyes or mouth havenít been a problem for me.

Other causes of swollen parotids include anorexia - If you could see me, you would know thatís not the problem :wink: and AIDS. I may have an AIDS screening done since I worked in the operating room 25+ years, but I really donít think thatís the problem.

The ENT doc suggested that it might be the lupus causing the swelling. Iíve been looking for a reference to that possible manifestation of lupus, but I donít find it. Have any of you had swollen parotid glands without having Sjogrens?

Yesterday, as I was checking out at a store, my mouth suddenly got very dry. I had some chewing gum with me and that relieved the situation. Iíve had a few other episodes where my mouth suddenly becomes so dry I can hardly talk. These episodes donít occur very often, but Iím wondering if this is how Sjogrens starts.

The ENT doc also mentioned the possibility of doing a lip biopsy. Iím leaning toward having it done Ė just to get a definite answer.

What do you think???

Missy
02-22-2008, 10:50 AM
I have had this problem a couple times over the years, and a past doctor thought I had Sjogren's at one point. Sometimes I have some borderline symptoms, but no official diagnosis. Prednisone cleared it up once, and antibiotics the second time. I was extremely ill and incapacitated for about a week each time. The first time, they thought it might be mono, too.

Anyway, I haven't had another flare up of this since I was officially diagnosed with Lupus (Lupus headed south to my kidneys and has focused its efforts there). Your paratitis sounds way worse than mine, but I did want you to know that you are not alone.

Good luck in finding the source of this and a treatment that works. I'll be thinking of you.

Saysusie
02-22-2008, 01:17 PM
It is not often that a lupus patient will have swollen Parotid glands without Sjgoren's. You mentioned that you do get excessive dry mouth. That is a symptoms of Sjgoren's. You do not have to have all symptoms of Sjgoren's to actually suffer from it. Did your doctor test you for eyelid wetness? For nasal wetness? The lip biopsy is a good test to determine if you do have Sjgoren's.

Here is a more thorough list of causes of swollen Parotid Glands from Patient Plus:

* Mumps, usually bilateral but can be unilateral at first. The swelling lasts 5 to 9 days with pyrexia and general malaise.
* Stone in salivary duct, gland swells with salivation.
* Various tumours of the parotid gland.
* Sjogren's disease affects females in 90% of cases, often with arthritis, a microcytic, hypochromic anaemia, raised ESR and mild fever. The age group is typically 40 to 60. It is an autoimmune phenomenon with an increased risk of non-Hodgkin's B cell lymphoma developing.
* Sarcoidosis affects the parotid gland in 10% of cases. The Heerfordt-Waldenstrom syndrome consists of sarcoidosis with parotid enlargement, fever, anterior uveitis, and facial nerve palsy.
* Bacterial parotitis occasionally occurs in dehydration or where drugs have reduced flow of saliva. There is progressive, painful swelling, aggravated by chewing.
* Wegener's Granulomatosis can presenting as unilateral parotid enlargement.
* Chronic bacterial parotitis may occur with calculi or stenosis of the ducts. In most cases, the chronic disease is autoimmune with superimposed bacterial infections and should not be designated as a chronic bacterial infection. Chronic parotitis often first presents to a dentist.5
* Rarely lymphocytic infiltration of the parotid can occur in HIV. It is commoner in children than adults.

I hope this was a bit helpful
Peace and Blessings
Saysusie

cheryl_v
02-22-2008, 03:22 PM
Just had to say that I love that picture :D . I so love cats, thats just too cute.

mnjodette
02-23-2008, 06:42 AM
Peggyj, I have Sjogren's, and was diagnosed by lip biopsy. Really a nearly painless process, by the way. Sjogren's is like lupus in that you don't always have positive blood tests. That's why the lip biopsy is done. Interestingly, I don't have swollen parotid glands, although I've had dry eyes for years, and now have very dry mouth as well. Hope you get some answers.

Peggyj
02-28-2008, 11:57 AM
Thanks for all the information and comments. I found them very interesting and helpful.

I saw the ENT doc yesterday. He assurred me that lupus can cause parotid glands to become enlarged. He isn't worried about stones, infection, etc. because I'm not having any pain or fever. He said the antibody tests are very dependable (my tests were negative for Sjorgens), but he would do a lip biopsy if I really wanted to do it. As he described the procedure, it was obvious that he really didn't want to encourage me to have the biopsy done.

I'm not sure what I would gain, except possibly a better understanding of all that is wrong with me. I'm still on Prednisone and the parotids seem to be slowly getting smaller. I think I'll just wait awhile and see how things go. PJ

Saysusie
02-28-2008, 11:59 AM
I'm glad that they are getting smaller Peggy, keep us posted!!

Peace and Blessings
Saysusie