A case of juvenile recurrent parotitis with thrombocytopenia

Abstract

Juvenile recurrent parotitis is defined as recurrent inflammatory parotitis in children of unknown etiology. Juvenile recurrent parotitis is the second most common cause of parotitis in childhood, only after mumps. It is a rare disease characterised by recurrent parotid inflammation associated with non-obstructive sialectasis. Here we present a 10-year-old boy with 6 recurrent episodes. The child came with complaints of bilateral swelling below the ear, fever and malaise for 1 week. He had recurrent episodes of painful swelling below both the ears for the past 2 years. He previously had 5 episodes which was unilateral associated with pain and fever, lasting for 7–10 days and treated with analgesics and antibiotics. During these episodes he had no dryness of mouth and eyes, increased salivation or altered taste sensation, joint pains/swelling, weight loss, night sweats and skin rashes.  There is no pain during eating and no family history. Lab findings reveal thrombocytopenia during each episode and resolved spontaneously. Relevant investigations ruled out Systemic Lupus Erythematous, Sjogren syndrome, Tuberculosis, Infectious mononucleosis and immunodeficiencies.  FNAC reveals granulomatous sialadenitis. Bone marrow examination shows normocellular marrow with increase in megakaryocytes. Serum ACE and IgG4 levels were normal. IgG levels were elevated. Child was started on oral steroids and improved clinically. This case depicts a rare association of recurrent parotitis with thrombocytopenia.