Summary about Disease
Uveoparotitis, also known as Heerfordt's Syndrome or Uveoparotid Fever, is a rare manifestation of sarcoidosis, a systemic inflammatory disease. It is characterized by inflammation of the uvea (the middle layer of the eye) and the parotid glands (major salivary glands located in front of the ears). Other symptoms related to cranial nerve involvement, particularly facial nerve palsy, are often seen.
Symptoms
Eye: Uveitis (eye redness, pain, blurred vision, sensitivity to light), glaucoma, cataracts (less common).
Parotid Glands: Swelling of the parotid glands (unilateral or bilateral), causing tenderness and pain.
Neurological: Facial nerve palsy (weakness or paralysis of facial muscles), other cranial nerve involvement possible but less common.
General: Fever, malaise, fatigue, weight loss, skin lesions (typical of sarcoidosis but not always present).
Causes
Uveoparotitis is a manifestation of sarcoidosis. The exact cause of sarcoidosis is unknown, but it is thought to be an immune response to an unknown trigger (likely environmental or infectious) in genetically predisposed individuals. Sarcoidosis is characterized by the formation of granulomas (clumps of inflammatory cells) in various organs, including the eyes and parotid glands.
Medicine Used
Treatment focuses on managing the inflammation and symptoms of sarcoidosis and uveitis. Common medications include:
Corticosteroids: Prednisone (oral), topical steroids for eye inflammation (eye drops). These are often the first-line treatment.
Immunosuppressants: Methotrexate, azathioprine, mycophenolate mofetil. Used to reduce the immune system's activity, especially when corticosteroids are not effective or have unacceptable side effects.
TNF-alpha inhibitors: Infliximab, adalimumab. Biologic agents used for severe or refractory cases.
Eye Drops: Cycloplegic eye drops (e.g., atropine, cyclopentolate) to relieve pain and prevent complications of uveitis.
Is Communicable
No, uveoparotitis (Heerfordt's Syndrome) is not communicable. It is not an infectious disease and cannot be spread from person to person. It is a manifestation of an inflammatory condition (sarcoidosis).
Precautions
Since the disease is not communicable, standard hygiene precautions (handwashing, etc.) are for general health and not specific to preventing transmission of uveoparotitis. However, individuals with uveoparotitis should:
Follow medical advice: Adhere strictly to prescribed medications and follow-up appointments.
Protect eyes: Wear sunglasses to protect against light sensitivity.
Manage stress: Stress can sometimes exacerbate symptoms.
Healthy Lifestyle: Maintain a healthy lifestyle through proper diet, regular exercise, and adequate sleep.
Regular eye exams: Monitor for glaucoma, cataracts or vision changes.
How long does an outbreak last?
The duration of an "outbreak" or flare-up of uveoparotitis can vary significantly depending on the severity of the sarcoidosis, the organs involved, and the individual's response to treatment. Acute flares can last for weeks to months. Chronic forms of sarcoidosis can have persistent or relapsing symptoms over years. Timely treatment can shorten the length of the flare-up.
How is it diagnosed?
Diagnosis typically involves:
Clinical Examination: Physical examination noting parotid gland swelling and eye symptoms. Neurological exam to check for cranial nerve palsies.
Eye Examination: Slit-lamp examination to diagnose uveitis.
Blood Tests: Elevated ACE (angiotensin-converting enzyme) levels, hypercalcemia, liver function tests.
Imaging Studies: Chest X-ray or CT scan to look for lung involvement (common in sarcoidosis).
Biopsy: Biopsy of affected tissue (e.g., parotid gland, skin lesion, lymph node) to confirm the presence of granulomas and rule out other causes.
Other Tests: Schirmer test to evaluate for dryness, pulmonary function test, gallium scan
Timeline of Symptoms
The onset and progression of symptoms can vary. A general timeline may look like:
Initial Phase: Non-specific symptoms like fatigue, fever, and malaise.
Early Phase: Gradual onset of eye symptoms (redness, pain, blurred vision) and parotid gland swelling.
Progression: Eye inflammation worsens, parotid swelling becomes more pronounced. Facial nerve palsy may develop.
Chronic Phase (If Untreated): Persistent or relapsing symptoms with potential for long-term complications (e.g., vision loss, chronic parotid gland dysfunction).
Treatment Phase: Symptoms improve with medication, although relapses are possible.
Important Considerations
Uveoparotitis is a rare presentation of sarcoidosis; sarcoidosis needs to be considered.
Early diagnosis and treatment are crucial to prevent long-term complications, particularly vision loss.
Treatment needs to be tailored to the individual patient based on disease severity and organ involvement.
Long-term monitoring is necessary to detect relapses and manage potential side effects of medications.
Sarcoidosis can affect multiple organ systems, so a comprehensive evaluation is essential.