Bilateral parotid enlargement

Causes of bilateral parotid enlargement include:

• local disease:
  • mumps - more commonly children than adults
  • parotitis
  • uveoparotid fever
  • sialectasis - especially if related to eating
  • Sjogren's syndrome
  • tumour infiltration
    
    
• systemic disease:
  • sarcoidosis
  • tuberculosis
  • alcoholism
  • myxoedema
  • Cushing's disease
  • diabetes/insulin resistance - about 25% of patients with overt or latent diabetes have bilateral asymptomatic enlargement of the parotid glands (1)
  • liver cirrhosis
  • gout
  • bulimia nervosa
  • HIV in children may cause bilateral parotid enlargement (2)
    
    
    
    
• drugs:
  • thiouracil
  • isoprenaline
  • phenylbutazone
  • high oestrogen contraceptive pills

Bilateral parotid enlargement may also be seen in:

• severe dehydration
• malnutrition

Notes:

• there have been case reports of involvement of the exocrine glands in cases of leukaemia (3)

Reference:

1. Pulse (2004), 64 (10), 80.
2. Hoare S. HIV infection in children--impact upon ENT doctors. Int J Pediatr Otorhinolaryngol. 2003 Dec;67 Suppl 1:S85-90.
3. Obama K et al. Adult T-cell leukemia predominantly involving exocrine glands. Eur J Haematol. 2004 Nov;73(5):332-9.