Walsh & Hoyt: Sarcoidosis: Salivary Gland Manifestations

The parotid glands may become enlarged early in the course of sarcoidosis. The enlargement typically is bilateral, nontender, and firm. Most patients in whom this condition occurs are otherwise asymptomatic; however, some develop a dry mouth. Others develop uveoparotid fever (Heerfordt syndrome; the Heerfordt-Waldenstrom syndrome), a condition characterized by bilateral enlargement of the parotid and lacrimal glands, fever, anterior uveitis, and unilateral or bilateral facial weakness. The site of inflammation causing the facial nerve paresis is unclear. It may affect the extracranial portion of the facial nerve passing through the diseased parotid glands, the portion of the nerve within the facial canal, or the intracranial portion of the nerve. Spontaneous regression of the parotid gland enlargement is the rule, and treatment thus is rarely needed.