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Recurrent Parotitis of Childhood

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41. Sjogren Syndrome (Treatment)

applicable?. J Rheumatol . 2005 Nov. 32(11):2225-32. . Pessler F, Emery H, Dai L, Wu YM, Monash B, Cron RQ, et al. The spectrum of renal tubular acidosis in paediatric Sjögren syndrome. Rheumatology (Oxford) . 2006 Jan. 45(1):85-91. . Baszis K, Toib D, Cooper M, French A, White A. Recurrent parotitis as a presentation of primary pediatric Sjögren syndrome. Pediatrics . 2012 Jan. 129(1):e179-82. . Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren's syndrome: a revised version (...) and lubrication, and nightly removal and cleaning of dental prostheses. The intermittent use of topical or systemic antifungal agents may be necessary to prevent recurrent infection. If topical antifungal agents are used, consultation with a compounding pharmacist is recommended in order to formulate sucrose-free suspensions or lozenges. (See the image below.) The dorsal tongue demonstrates hyperplastic candidiasis with focal erosions and a brown hairy tongue. Ulcerated fissures are observed on the corners

2014 eMedicine Pediatrics

42. Human Immunodeficiency Virus Infection (Overview)

in the United States but still exist in developing countries. Sexual abuse of children and high-risk behaviors in adolescents also contribute to youth HIV infection. A variety of signs and symptoms should alert the clinician to the possibility of HIV infection in a child. The presentations include recurrent bacterial infections, unrelenting fever, unrelenting diarrhea, unrelenting thrush, recurrent pneumonia, chronic parotitis, generalized lymphadenopathy, delay in development with failure to thrive (...) percentage fell by 19%. [ ] Combining age effects and baseline CD4 percentage resulted in more than 90% recovery when HAART was initiated in children with mild immunosuppression at any age or advanced immunosuppression at an age younger than 3 years. Most of the immunologic benefits of HAART remained significant at 4 years. Signs and symptoms History Signs and symptoms of pediatric HIV infection include the following: Unusually frequent and severe occurrences of common childhood bacterial infections

2014 eMedicine Pediatrics

43. Immunoglobulin A Deficiency (Diagnosis)

described 63 Israeli children with SIgAD followed for 10 years, with malignancies diagnosed in 3 children (4.8%). [ ] Patients with IgAD who have a compensatory increase in IgM in their upper respiratory tract secretions and GI fluids tend to be less symptomatic. Note that patients with total IgAD are usually more symptomatic than patients partial IgAD. A previously unrecognized clear association of SIgAD with recurrent parotitis of childhood (PTC) was demonstrated by Fazekas et al in an Austrian (...) with recurrent parotitis of childhood. Pediatr Infect Dis J . 2005 May. 24(5):461-2. Shkalim V, Monselise Y, Mosseri R, Finkelstein Y, Garty BZ. Recurrent parotitis in selective IgA deficiency. Pediatr Allergy Immunol . 2004 Jun. 15(3):281-3. . Tar I, Kiss C, Marodi L, Marton IJ. Oral and dental conditions of children with selective IgA deficiency. Pediatr Allergy Immunol . 2008 Feb. 19(1):33-6. . Nikfarjam J, Pourpak Z, Shahrabi M, Nikfarjam L, Kouhkan A, Moazeni M, et al. Oral manifestations in selective

2014 eMedicine.com

44. Sjogren Syndrome (Follow-up)

applicable?. J Rheumatol . 2005 Nov. 32(11):2225-32. . Pessler F, Emery H, Dai L, Wu YM, Monash B, Cron RQ, et al. The spectrum of renal tubular acidosis in paediatric Sjögren syndrome. Rheumatology (Oxford) . 2006 Jan. 45(1):85-91. . Baszis K, Toib D, Cooper M, French A, White A. Recurrent parotitis as a presentation of primary pediatric Sjögren syndrome. Pediatrics . 2012 Jan. 129(1):e179-82. . Vitali C, Bombardieri S, Jonsson R, et al. Classification criteria for Sjögren's syndrome: a revised version (...) and lubrication, and nightly removal and cleaning of dental prostheses. The intermittent use of topical or systemic antifungal agents may be necessary to prevent recurrent infection. If topical antifungal agents are used, consultation with a compounding pharmacist is recommended in order to formulate sucrose-free suspensions or lozenges. (See the image below.) The dorsal tongue demonstrates hyperplastic candidiasis with focal erosions and a brown hairy tongue. Ulcerated fissures are observed on the corners

2014 eMedicine Pediatrics

45. Mumps (Diagnosis)

chronic arthritis, arthralgias, and nephritis. [ ] Previous Next: Causes Mumps is typically caused by a single-stranded RNA virus belonging to the Paramyxovirus genus. Humans serve as the only natural host for the mumps virus. Other viruses implicated in recurrent parotitis are influenza, echovirus, parainfluenza (types 1 and 3), and coxsackievirus A. More rare causes of parotitis seen in persons with HIV infection are adenovirus or cytomegalovirus. Risk factors include lack of immunization (...) which time prodromal symptoms occur and last anywhere from 3-5 days. After the prodrome, the symptoms of the virus depend on which organ is affected. The most common presentation is a parotitis, which occurs in 30-40% of patients. Other reported sites of infection are the testes, pancreas, eyes, ovaries, central nervous system, joints, and kidneys. A patient is considered infectious from about 3 days before the onset and up to 4 days after the start of active parotitis. Infections can

2014 eMedicine Emergency Medicine

46. Mumps (Overview)

chronic arthritis, arthralgias, and nephritis. [ ] Previous Next: Causes Mumps is typically caused by a single-stranded RNA virus belonging to the Paramyxovirus genus. Humans serve as the only natural host for the mumps virus. Other viruses implicated in recurrent parotitis are influenza, echovirus, parainfluenza (types 1 and 3), and coxsackievirus A. More rare causes of parotitis seen in persons with HIV infection are adenovirus or cytomegalovirus. Risk factors include lack of immunization (...) which time prodromal symptoms occur and last anywhere from 3-5 days. After the prodrome, the symptoms of the virus depend on which organ is affected. The most common presentation is a parotitis, which occurs in 30-40% of patients. Other reported sites of infection are the testes, pancreas, eyes, ovaries, central nervous system, joints, and kidneys. A patient is considered infectious from about 3 days before the onset and up to 4 days after the start of active parotitis. Infections can

2014 eMedicine Emergency Medicine

47. Primary Sjögren syndrome in a 2-year-old patient: role of the dentist in diagnosis and dental management with a 6-year follow-up. (PubMed)

of underdiagnosed cases. Differential conditions should be considered, especially the ones that promote xerostomia, such as diabetes, ectodermal dysplasia, rheumatoid arthritis, scleroderma, systemic lupus erythematosus, sarcoidosis, lymphoma, HIV and HTLV infection. Conditions associated with parotid enlargement should also be excluded, including juvenile recurrent parotitis (JRP), sialadenosis, sarcoidosis, lymphoma, infectious parotitis caused by streptococcal and staphylococcal infections, viral infections (...) Primary Sjögren syndrome in a 2-year-old patient: role of the dentist in diagnosis and dental management with a 6-year follow-up. BACKGROUND. Primary Sjögren syndrome is a rare autoimmune disease, especially in children, mainly affecting girls (77%), and usually diagnosed around 10 years of age. Diagnosis during childhood is difficult, especially because of the diversity of the clinical presentation and difficulty obtaining reliable history data, accounting for a higher frequency

2011 International Journal of Paediatric Dentistry

48. Mumps

, due to iodides, phenylbutazone, or propylthiouracil ) Laboratory diagnosis of mumps is necessary if disease is Unilateral Recurrent Occurs in previously immunized patients Causes prominent involvement of tissues other than the salivary glands Mumps testing is also recommended for all patients with parotitis lasting ≥ 2 days without an identified cause. RT-PCR is the preferred method of diagnosis; however, serologic testing of acute and convalescent sera by complement fixation or enzyme-linked (...) , but testosterone production and fertility are usually preserved. Other complications include meningoencephalitis and pancreatitis. Laboratory diagnosis is done mainly for public health purposes and when disease manifestations are atypical, such as absence of parotitis, unilateral or recurrent parotitis, parotitis in previously immunized patients, or prominent involvement of tissues other than the salivary glands. Universal vaccination is imperative unless contraindicated (eg, by pregnancy or severe

2013 Merck Manual (19th Edition)

49. Salivary Gland Disorders

cavity, most frequently Staphylococcus aureus . Chronic bacterial infection may occur on a background of a gland previously damaged by stones, irradiation or autoimmune disease. Chronic infection destroys the glandular elements of the salivary glands and can impair the protective functions of saliva, leading to dental infections and disease. It consequently often first presents to a dentist. Recurrent parotitis of childhood. Recurrent episodes of swelling and pain of the parotid gland with fever (...) . With chronic infections, where duct obstruction is identified, stones or strictures can be removed, promoting saliva flow. Gland excision may sometimes be required where problems become recurrent. NB : diseases of the salivary glands are rare in children (with the exception of acute parotitis usually due to mumps), so that any acute or chronic sialadenitis not responding to conservative treatment should be referred for specialist opinion. [ ] Complications Complications of mumps parotitis include orchitis

2008 Mentor

50. Sjögren's Syndrome

of the mouth. Speaking for long periods of time causes hoarseness. Dental and periodontal problems. Oral candidiasis and angular cheilitis. Dry eyes tend to cause a gritty sensation. There is a predisposition to blepharitis and the eyes may be sticky in the morning. There are a number of other features that can occur with the disease: There may be recurrent parotitis, usually bilateral. Glands are usually enlarged but this is not often the presenting feature. Dryness of the mucosa of the trachea (...) with age but age of onset is usually in the 30s or 40s. Rarely, it can occur in childhood. It is up to 20 times more common in women than in men, and men who have the condition tend to be less severely affected by it. Risk factors There are as yet no chromosomal regions identified by linkage studies (eg, twin studies) which yield definitive proof of a genetic component but circumstantial evidence is heavily in favour of a genetic aetiology [ ] . There is a genetic predisposition for the disease

2008 Mentor

51. Congenital Throat Problems

. There are reports that these are associated with recurrent acute suppurative thyroiditis of childhood. Fourth branchial cleft cysts : present as a left-sided, anterior lesion at the lowest portion of the sternocleidomastoid muscle. They are extremely rare and also reportedly associated with recurrent acute suppurative thyroiditis of childhood. Thymic abnormalities Incomplete descent of the thymus into the chest can give rise to thymic cysts along the descent line and thymic cysts can be sequestered along (...) paralysis presents in the infant, with varying degrees of respiratory distress. There may be a history of recurrent chest infections secondary to aspiration. Surgical intervention is frequent although the priority is to stabilise the airway, followed by a thorough evaluation of the problem. Unilateral paralysis may be asymptomatic or present with a hoarse cry and difficulty in feeding. These infants tend to have a stable airway and so investigations can be carried out less urgently. Many manage

2008 Mentor

52. Congenital HIV Infection and its Prevention

will be identified before delivery, so that HIV infection of the child is unlikely/anticipated. However, appropriate vigilance and suspicion of HIV infection in unwell children are important. Impairment of cellular immune defences (the type found in HIV infection) should be suspected in children who present with: Recurrent bacterial infections, particularly invasive infections like meningitis, septicaemia and pneumonia. Recurrent/frequent common childhood infections such as otitis media, chest infection, urinary (...) Congenital HIV Infection and its Prevention Congenital HIV and Childhood AIDS information. Patient | Patient TOPICS Try our Symptom Checker TREATMENT RESOURCES Try our Symptom Checker PROFESSIONAL Upgrade to Patient Pro / / Search Congenital HIV and Childhood AIDS Authored by , Reviewed by | Last edited 4 Apr 2015 | Certified by This article is for Medical Professionals Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based

2008 Mentor

53. Dental and Periodontal Diseases

diabetes, immunocompromise, smoking and drug-induced gum disorders. Look for facial swelling, regional lymphadenopathy, altered tooth appearance and gum swelling. Alternative diagnoses to consider include: Infections such as , , and facial cellulitis. such as a stone, infection (parotitis) or / . Intraoral or salivary gland neoplasm. Management in primary care - the patient needs to be seen by a dental practitioner. In the interim, pain can be managed with regular analgesics such as NSAIDs (advise (...) treated, it may lead to recurrent ulcerative gingivitis for many years with halitosis, gingival bleeding and recession of the gums. Inadequate treatment can also (rarely) lead to noma (rapidly spreading gangrene of the lips and cheeks) - more likely in malnourished or immunocompromised individuals. Periodontitis Untreated gingivitis can advance to periodontitis which is an inflammation of the periodontal ligament (which attaches the tooth to the bone) and bone. Toxins produced by the bacteria

2008 Mentor

54. Childhood AIDS

that HIV infection of the child is unlikely/anticipated. However, appropriate vigilance and suspicion of HIV infection in unwell children are important. Impairment of cellular immune defences (the type found in HIV infection) should be suspected in children who present with: Recurrent bacterial infections, particularly invasive infections like meningitis, septicaemia and pneumonia. Recurrent/frequent common childhood infections such as otitis media, chest infection, urinary tract infections, sinusitis (...) , neurodevelopmental, ophthalmology, TB. Additional tests in line with drug therapy protocols and clinical status. Staging A number of clinical staging systems are available, the most common used being the Centers for Disease Control and Prevention (CDC) paediatric HIV classification and the WHO classification systems : Category N - asymptomatic. Category A - mildly symptomatic. 2 or more of: Lymphadenopathy. Hepatomegaly. Splenomegaly. Dermatitis. Parotitis. Recurrent/persistent upper respiratory tract infection

2008 Mentor

55. Primary Sjögren's syndrome in children and adolescents: are proposed diagnostic criteria applicable? (PubMed)

reviewed for pediatric and AECG criteria for pSS. The presence of > or = 4 criteria was required to satisfy the respective classification criteria. The expert clinical opinion of pediatric rheumatologists was considered the gold standard for diagnosis.A total of 24/62 (39%) cases satisfied the AECG criteria; 47/62 (76%) satisfied the proposed pediatric criteria. Inclusion of recurrent parotitis increased the sensitivity of the pediatric clinical criteria. From the cases, 78/133 (59%) satisfied (...) the pediatric oral symptom criteria; only 6/78 (8%) had xerostomia in the absence of recurrent parotitis. There was no reported case of recurrent conjunctivitis in the absence of keratoconjunctivitis sicca. We found 101/130 (78%) cases had at least one positive autoantibody test result [antinuclear antibodies (ANA), rheumatoid factor (RF), SSA, SSB]; 78/123 (63%) had autoantibodies to SSA or SSB.The AECG adult criteria for pSS should not be applied to children as the sensitivity is unacceptably low

2005 Journal of Rheumatology

56. Recurrent parotitis. (PubMed)

Recurrent parotitis. 8499014 1993 03 16 2018 11 13 1468-2044 68 1 1993 Jan Archives of disease in childhood Arch. Dis. Child. Recurrent parotitis. 151 Mulcahy D D Isaacs D D eng Case Reports Comment Letter England Arch Dis Child 0372434 0003-9888 AIM IM Arch Dis Child. 1992 Aug;67(8):1036-7 1303637 Autoimmune Diseases complications Child Common Variable Immunodeficiency complications Female Humans Parotitis immunology Recurrence 1993 1 1 1993 1 1 0 1 1993 1 1 0 0 ppublish 8499014 PMC1029212

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1993 Archives of Disease in Childhood

57. Recurrent parotitis. (PubMed)

Recurrent parotitis. 8503688 1993 06 25 2018 11 13 1468-2044 68 4 1993 Apr Archives of disease in childhood Arch. Dis. Child. Recurrent parotitis. 526-7 Lawson J O JO Hobbs J R JR eng Letter England Arch Dis Child 0372434 0003-9888 0 Immunoglobulin A, Secretory AIM IM Child Humans Immunoglobulin A, Secretory metabolism Parotitis immunology Recurrence 1993 4 1 1993 4 1 0 1 1993 4 1 0 0 ppublish 8503688 PMC1029290 Arch Dis Child. 1992 Aug;67(8):1036-7 1303637 Public Health. 1992 Nov;106(6):429-36

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1993 Archives of Disease in Childhood

58. Selective IgA deficiency in children with recurrent parotitis of childhood. (PubMed)

Selective IgA deficiency in children with recurrent parotitis of childhood. Recurrent parotitis of childhood is defined as the relapsing form of juvenile (idiopathic) parotitis and represents a rare inflammatory disorder of the parotid gland with potentially significant morbidity. We reviewed the charts of patients who were diagnosed with inflammatory parotid diseases in our institution between 1992 and 2002. There were 91 patients presenting with juvenile parotitis (1 of 6117 of all clinical (...) visits). Of these 91 cases, 23 patients (28%) had the relapsing form of juvenile parotitis, and the median number of episodes was 5 (range, 2-20). Laboratory investigations revealed that 5 patients had selective IgA deficiency. The prevalence (22%) is different from the cumulative prevalence of IgA deficiency in a healthy population (0.3%; P < 0.001).

2005 Pediatric Infectious Dsease Journal

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