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Wegener's granuloma – presenting as a unilateral parotid swelling

Published online by Cambridge University Press:  29 June 2007

R. Benson-Mitchell*
Affiliation:
Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London.
N. Tolley
Affiliation:
Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London.
C. B. Croft
Affiliation:
Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London.
D. Roberts
Affiliation:
Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London.
*
Mr R. Benson-Mitchell, ENT Department, Southend General Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex SS0 0RY.

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.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1994

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