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Saro-Buendía M, Torres-García L, Mossi Martínez C, Battig Arriagada E, Carreres Polo J, Perolada Valmaña JM, Armengot Carceller M. Management of iodine contrast induced salivary gland swelling (sialadenitis): experiences from an observational study. Acta Otolaryngol 2023; 143:64-69. [PMID: 36595461 DOI: 10.1080/00016489.2022.2162121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Iodine contrast-induced sialadenitis (CIS) is an uncommon adverse effect to iodine-containing contrast exposition. There is scarce literature about its clinical course and demography. OBJECTIVES (1) To determine the clinical course and management of CIS. (2) To understand if CIS might be as rare as reported. MATERIAL AND METHODS A 2-month prospective observational study was conducted in the emergency room of a tertiary institution. ENT physicians on call received clinical formation about CIS while emergency physicians did not. During the study period, patients admitted at the emergency room matching the clinical and radiological features of CIS, were included. Information about demographics, iodine exposure, diagnostic workup, clinical course, and management was analyzed. RESULTS ENT physicians on call detected 4 cases, however, emergency physicians did not. Patients were aged 68-76 years and presented a bilateral submandibular gland swelling debuting 12 to 72 h after an exposure to iodinated contrast. Characteristic ultrasonographic findings supported the diagnosis and the clinical course was self-limited after 60 to 150 h. CONCLUSIONS AND SIGNIFICANCE Physicians' familiarity with CIS allows its detection and avoids costly and potentially harmful therapeutic/diagnostic efforts. The incidence is probably underestimated; however, further incidence studies are needed.
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Affiliation(s)
- Miguel Saro-Buendía
- Unit of Laryngology-Head & Neck Surgery, Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain.,Department of Surgery, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Lidia Torres-García
- Unit of Laryngology-Head & Neck Surgery, Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain.,Department of Surgery, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Claudia Mossi Martínez
- Unit of Neuroradiology and Head & Neck Radiology, Department of Radiology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain
| | - Eduardo Battig Arriagada
- Unit of Neuroradiology and Head & Neck Radiology, Department of Radiology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain
| | - Joan Carreres Polo
- Unit of Neuroradiology and Head & Neck Radiology, Department of Radiology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain
| | - José María Perolada Valmaña
- Unit of Laryngology-Head & Neck Surgery, Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain.,Department of Surgery, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Miguel Armengot Carceller
- Unit of Laryngology-Head & Neck Surgery, Department of Otorhinolaryngology, La Fe University and Polytechnic Hospital, University of Valencia, Valencia, Spain.,Department of Surgery, Faculty of Medicine, University of Valencia, Valencia, Spain
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Longo C, De Robertis R, Valdo M, Montemezzi S. A case of acute bilateral iodine-induced submandibular sialadenitis: Ultrasound findings. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:70-73. [PMID: 34324207 DOI: 10.1002/jcu.23049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 06/13/2023]
Abstract
Acute sialadenitis is a rare adverse reaction to iodine-based contrast agents. Ultrasound (US) is usually the preferred imaging method to evaluate the salivary glands; along with clinical and anamnestic data, US allows the diagnosis of contrast-induced sialadenitis. We present a case of acute bilateral submandibular sialadenitis induced by intravenous administration of iodine-based contrast media for a contrast-enhanced computed tomography scan diagnosed by US.
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Affiliation(s)
- Chiara Longo
- Department of Radiologyss, Ospedale G.B. Rossi-University of Verona, Verona, Italy
| | - Riccardo De Robertis
- Department of Radiology, Ospedale Civile Maggiore-Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Moreno Valdo
- Department of Radiology, Ospedale Civile Maggiore-Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Stefania Montemezzi
- Department of Radiology, Ospedale Civile Maggiore-Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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Jiao A, Farsad K, McVinnie DW, Jahangiri Y, Morrison JJ. Characterization of Iodide-induced Sialadenitis: Meta-analysis of the Published Case Reports in the Medical Literature. Acad Radiol 2020; 27:428-435. [PMID: 31178376 DOI: 10.1016/j.acra.2019.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 05/02/2019] [Accepted: 05/11/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To evaluate the patient presentation of postcontrast sialadenitis and factors associated with its duration of symptoms through meta-analysis of case reports. BACKGROUND Acute iodide sialadenitis, or "iodide mumps," is a rare adverse reaction to iodinated contrast causing salivary gland swelling. The condition may be underdiagnosed, with researchers postulating that its true incidence may be close to 1-2%. METHODS AND MATERIALS This study was a meta-analysis performed using PRISMA Reporting Standards. A literature search with no language restriction was performed of the Medline database, primarily through PubMed, using keywords: "iodide mumps," "iodide sialadenitis," "sialadenitis," "salivary enlargement," "contrast reaction," "parotid swelling," and "submandibular swelling." Matching case reports and case series were reviewed, and data regarding the subjects' demographics, renal function, contrast administration, and symptoms were extracted. Uni- and multivariate linear regression analyses were applied to assess the predicting factors of a prolonged symptoms duration. RESULTS Sixty-five case reports and case series were identified, with 77 cases of iodide-induced sialadenitis. Two cases were unpublished and from the author's institution. Reported subjects' median age was 63 years, and 61% (47/77) were males. Median time to onset was 16 hours, and symptoms resolved in a median of 3 days after the initial onset. Twenty-seven subjects (35%, 27/77) were reported to have an impaired renal function at baseline. Administration of nonionic, low osmolarity contrast medium was reported most frequently (53%, 41/77). There was no difference in resolution of symptoms among subjects with impaired versus normal renal function. Symptoms were resolved in all cases over a median of 3 days with no statistically significant difference between those who received therapeutic intervention and those who did not (p = 0.430). Older age and longer time to onset were significantly associated with longer duration of symptoms in both uni- and multivariate linear regression models, and presence of tenderness demonstrated statistical significance associated with longer duration of symptoms in the univariate model. CONCLUSION Postcontrast sialadenitis is a rare reaction to iodinated contrast media. Older age and a longer time to onset of symptoms are associated with longer duration of symptoms.
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Affiliation(s)
- Albert Jiao
- Michigan State University College of Human Medicine, Secchia Center, Grand Rapids, Michigan
| | - Khashayar Farsad
- Charles T. Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, Oregon
| | | | - Younes Jahangiri
- Charles T. Dotter Department of Interventional Radiology, Oregon Health and Science University, Portland, Oregon
| | - James J Morrison
- Advanced Radiology Services, 3264 North Evergreen Drive, Grand Rapids, MI 49525.
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Iodide mumps: A rare complication of iodine-containing contrast after coronary angioplasty. Anatol J Cardiol 2020; 23:110-111. [PMID: 32011325 PMCID: PMC7040874 DOI: 10.14744/anatoljcardiol.2019.64946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Iodide Mumps Complicating Coronary and Carotid Angiography. Heart Lung Circ 2017; 26:e14-e15. [DOI: 10.1016/j.hlc.2016.05.126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/02/2016] [Accepted: 05/06/2016] [Indexed: 11/21/2022]
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Zhang G, Li Y, Zhang R, Guo Y, Ma Z, Wang H, Zhang L, Li T. Acute Submandibular Swelling Complicating Arteriography With Iodide Contrast: A Case Report and Literature Review. Medicine (Baltimore) 2015; 94:e1380. [PMID: 26287428 PMCID: PMC4616457 DOI: 10.1097/md.0000000000001380] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Iodide mumps is an uncommon condition induced by iodide-containing contrast. We present the first reported case of iodide mumps in mainland China, which occurred after carotid artery intervention.The patient, a 65-year-old Chinese male, had a history of dizziness, hypertension, diabetes, and right arm weakness. He had no history of allergies and had never previously received iodide-containing contrast. The patient's kidney function and other laboratory findings were normal. He underwent stenting of the left internal carotid artery (LICA) opening and received approximately 250 mL of a nonionic contrast agent (ioversol). Approximately 5 hours after angioplasty, bilateral local swellings were noted near the mandible; the masses were moderately firm and nontender.Iodide mumps was diagnosed in the patient. Intravenous dexamethasone (10 mg) was administered. The submandibular glands had shrunk by 11 hours after angioplasty, and they gradually became softer. The mandibular salivary glands had completely recovered by 5 days after surgery.Iodide mumps represents a rare late reaction to iodine-containing contrast media. This condition can occur in any patient receiving any iodinated contrast agent and may recur upon repeated exposure, but self-resolution can be expected within 2 weeks. All clinicians who use contrast media or iodide should be aware of this condition.
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Affiliation(s)
- Guilian Zhang
- From the Department of Neurology, Second Affiliated Hospital, Medical School of Xi'an Jiaotong University (GZ, RZ, YG, ZM, HW, TL); Department of Stomatology, Affiliated Children's Hospital, Medical School of Xi'an Jiaotong University, Xi'an (YL); and Department of Neurology, Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, Shaanxi Province, China (LZ)
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Abstract
Patients with salivary gland disease present with certain objective and/or subjective signs. An accurate diagnosis for these patients requires a range of techniques that includes the organized integration of information derived from their history, clinical examination, imaging, serology, and histopathology. This article highlights the signs and symptoms of the salivary gland disorders seen in the Salivary Gland Center, and emphasizes the methodology used to achieve a definitive diagnosis and therapy.
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Affiliation(s)
- Louis Mandel
- Department of Oral and Maxillofacial Surgery, Salivary Gland Center, Columbia University College of Dental Medicine, 630 West 168th Street, New York, NY 10032, USA.
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Iodide Mumps After Trans-arterial Chemoembolization Procedure for Treatment of Hepatocellular Carcinoma: A Case Report. J Gastrointest Cancer 2014; 45 Suppl 1:195-7. [PMID: 24908402 DOI: 10.1007/s12029-014-9627-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chen S, Paul BC, Myssiorek D. An Algorithm Approach to Diagnosing Bilateral Parotid Enlargement. Otolaryngol Head Neck Surg 2013; 148:732-9. [DOI: 10.1177/0194599813476669] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objective This contemporary review aims to categorize the disease entities that cause bilateral parotid enlargement and to develop a question-based algorithm to improve diagnosis of bilateral parotid masses. Data Sources A PubMed search for bilateral and parotid showed 818 results. Of these, 68 relevant studies were reviewed to compile a list of disease processes that can cause bilateral parotid enlargement. Review Methods A total of 22 diseases entities were reviewed. The disease processes were initially grouped into 6 categories based on etiology: sialadenosis, infection, neoplasm, autoimmune, iatrogenic, and miscellaneous. For each lesion, the incidence, history, and physical examination were compiled in a matrix. Conclusion After reviewing the matrix, it was clear that grouping diseases based on specific history and physical findings limits the differential diagnosis. The most important factors included disease incidence, timing of onset, nodular or diffuse, pain, and overlying skin changes. With this algorithm, the differential diagnosis can be limited from 28 to 7 or fewer likely diagnoses for a given presentation. Implications for Practice Bilateral parotid disease has a wide differential diagnosis with an expanding number of available tests. An algorithm, based solely on data obtained from the history and physical examination in the first patient encounter, may reduce the differential and aid the clinician in deciding on further workup and treatment. Following the algorithm presented here should allow the clinician to arrive at a diagnosis rapidly without ordering unnecessary tests and wasting resources.
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Affiliation(s)
- Si Chen
- Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York, USA
| | - Benjamin C. Paul
- Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York, USA
| | - David Myssiorek
- Department of Otolaryngology–Head and Neck Surgery, New York University School of Medicine, New York, New York, USA
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Jain R, Kanjirakadavath B, Krishnan MN. Contrast-induced acute sialadenitis: iodide mumps. HEART ASIA 2013; 5:126. [PMID: 27326104 DOI: 10.1136/heartasia-2013-010359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 06/07/2013] [Indexed: 11/04/2022]
Affiliation(s)
- Rakesh Jain
- Department of Cardiology , Government Medical College , Kozhikode, Kerala , India
| | - Babu Kanjirakadavath
- Department of Cardiology , Government Medical College , Kozhikode, Kerala , India
| | - M N Krishnan
- Department of Cardiology , Government Medical College , Kozhikode, Kerala , India
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