Uveoparotid Fever
HLA-DRB1* alleles and symptoms associated with Heerfordt's syndrome in sarcoidosis. (1/2)
(+info)Rare manifestations of sarcoidosis in modern era of new diagnostic tools. (2/2)
BACKGROUND & OBJECTIVES: Growing body of literature on sarcoidosis in India has led to an increased awareness of the disease. With the advent of better imaging tools hitherto under-recognized manifestations of sarcoidosis are likely to be better recognized. We sought to study the rare clinical and radiological manifestations (<5%) in patients with sarcoidosis. METHODS: Retrospective review of records of 164 patients with histopathologically proven sarcoidosis seen over six years in a tertiary care centre in north India, was done. RESULTS: Fifty four rare manifestations were observed in 164 patients. Acute presentation in the form of Lofgren syndrome was seen in eight (4.9%) and Heerfordt's syndrome in two (1.2%) patients. Musculoskeletal manifestations included chronic sarcoid arthritis in three (1.8%), deforming arthritis and bone erosion in one (0.6%) each. Rare initial presentation with dilated cardiomyopathy in one (0.6%), complete heart block in two (1.2%), bilateral sequential facial nerve palsy in two (1.2%), and pyrexia of unknown origin was seen in one (0.6%) patient. Other rare manifestations included chronic respiratory failure in one (0.6%), dysphagia in one (0.6%), sicca syndrome in five (3%), massive splenomegaly in one (0.6%), portal hypertension in two (1.2%), hypersplenism, gastric sarcoidosis, ninth and tenth cranial nerve palsies, moderate pericardial effusion and nephrocalcinosis in one (0.6%) each, and pulmonary artery hypertension in two (1.2%) patients. Rare radiological manifestations included moderate pleural effusion in two (1.2%), pleural thickening in five (3%), calcification of intrathoracic lymph nodes in four (2.4%), alveolar (nodular) sarcoidosis in three (1.8%), and myocardial uptake of 18F-fluorodeoxyglucose (F-18 FDG) in two (1.2%) patients. Fourteen patients had airways obstruction and behaved typically like seasonal bronchial asthma with excellent response to corticosteroids. INTERPRETATION & CONCLUSIONS: Increased awareness of rare manifestations will facilitate better management of these patients. With increasing use of modern diagnostic tools, manifestations hitherto considered rare, are likely to be recognized more frequently in the future. (+info)Uveoparotid fever, also known as Heerfordt's syndrome, is not precisely defined as a fever. Instead, it is a rare manifestation of sarcoidosis, a multisystem granulomatous disorder of unknown cause. The condition is named after the Danish ophthalmologist, Christian Frederik Heerfordt, who first described it in 1909.
Uveoparotid fever is characterized by the following symptoms:
1. Uveitis: Inflammation of the uveal tract, which includes the iris, ciliary body, and choroid, leading to eye pain, redness, photophobia (sensitivity to light), blurred vision, and floaters.
2. Parotid gland enlargement: Swelling of one or both parotid glands, located in front of and below the ears.
3. Facial palsy: Weakness or loss of movement on one side of the face, similar to Bell's palsy.
4. Fever: Elevated body temperature may be present but is not always a consistent finding.
Other possible symptoms associated with sarcoidosis include cough, shortness of breath, skin rashes, fatigue, and joint pain. The diagnosis typically involves a combination of clinical presentation, imaging studies, and tissue biopsy to confirm the presence of noncaseating granulomas, which are characteristic of sarcoidosis. Treatment usually includes corticosteroids and immunosuppressive therapy to manage inflammation and prevent complications.
Fever, also known as pyrexia or febrile response, is a common medical sign characterized by an elevation in core body temperature above the normal range of 36.5-37.5°C (97.7-99.5°F) due to a dysregulation of the body's thermoregulatory system. It is often a response to an infection, inflammation, or other underlying medical conditions, and it serves as a part of the immune system's effort to combat the invading pathogens or to repair damaged tissues.
Fevers can be classified based on their magnitude:
* Low-grade fever: 37.5-38°C (99.5-100.4°F)
* Moderate fever: 38-39°C (100.4-102.2°F)
* High-grade or severe fever: above 39°C (102.2°F)
It is important to note that a single elevated temperature reading does not necessarily indicate the presence of a fever, as body temperature can fluctuate throughout the day and can be influenced by various factors such as physical activity, environmental conditions, and the menstrual cycle in females. The diagnosis of fever typically requires the confirmation of an elevated core body temperature on at least two occasions or a consistently high temperature over a period of time.
While fevers are generally considered beneficial in fighting off infections and promoting recovery, extremely high temperatures or prolonged febrile states may necessitate medical intervention to prevent potential complications such as dehydration, seizures, or damage to vital organs.