Swelling of the submandibular glands after administration of low-osmolarity contrast agent: Ultrasound findings

Federici, Margherita; Guarna, T.; Manzi, M.; Longa, G. Della; Renzi, Paolo Di; Bellelli, A

doi:10.1016/j.jus.2008.03.003

Cited by 9 publications

(6 citation statements)

References 4 publications

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“…After administration of iodine contrast, the majority (98%) is excreted in the urine, with the remainder eliminated through exocrine secretions such as saliva, sweat, and gastric juices, as well as through the hepatobiliary system (14,53). Salivary glands are known to concentrate iodide up to 30-100 times the plasma inorganic iodide level (12,22). Previous studies have shown that gland enlargement correlates with high plasma iodide levels, with symptoms developing after plasma iodide levels rise above 11,000 mm/100 mL (8,36).…”

Section: Discussionmentioning

confidence: 99%

Characterization of Iodide-induced Sialadenitis: Meta-analysis of the Published Case Reports in the Medical Literature

et al. 2020

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To evaluate the patient presentation of postcontrast sialadenitis and factors associated with its duration of symptoms through meta-analysis of case reports. Background: Acute iodide sialadenitis, or "iodide mumps," is a rare adverse reaction to iodinated contrast causing salivary gland swelling. The condition may be underdiagnosed, with researchers postulating that its true incidence may be close to 1-2%. Methods and Materials: This study was a meta-analysis performed using PRISMA Reporting Standards. A literature search with no language restriction was performed of the Medline database, primarily through PubMed, using keywords: "iodide mumps," "iodide sialadenitis," "sialadenitis," "salivary enlargement," "contrast reaction," "parotid swelling," and "submandibular swelling." Matching case reports and case series were reviewed, and data regarding the subjects' demographics, renal function, contrast administration, and symptoms were extracted. Uni-and multivariate linear regression analyses were applied to assess the predicting factors of a prolonged symptoms duration. Results: Sixty-five case reports and case series were identified, with 77 cases of iodide-induced sialadenitis. Two cases were unpublished and from the author's institution. Reported subjects' median age was 63 years, and 61% (47/77) were males. Median time to onset was 16 hours, and symptoms resolved in a median of 3 days after the initial onset. Twenty-seven subjects (35%, 27/77) were reported to have an impaired renal function at baseline. Administration of nonionic, low osmolarity contrast medium was reported most frequently (53%, 41/77). There was no difference in resolution of symptoms among subjects with impaired versus normal renal function. Symptoms were resolved in all cases over a median of 3 days with no statistically significant difference between those who received therapeutic intervention and those who did not (p = 0.430). Older age and longer time to onset were significantly associated with longer duration of symptoms in both uni-and multivariate linear regression models, and presence of tenderness demonstrated statistical significance associated with longer duration of symptoms in the univariate model. Conclusion: Postcontrast sialadenitis is a rare reaction to iodinated contrast media. Older age and a longer time to onset of symptoms are associated with longer duration of symptoms.

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Section: Discussionmentioning

confidence: 99%

Characterization of Iodide-induced Sialadenitis: Meta-analysis of the Published Case Reports in the Medical Literature

et al. 2020

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“…Occasionally, the involvement of other glands was reported (thyroid, lacrimal gland and pancreas). Facial nerve palsy, erythematous dermatitis and allergic vasculitis are some of the other associated adverse reactions reported with iodinated contrast media (5) .…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, some authors have reported imaging findings of iodide mumps which are consistent with a diagnosis of acute sialadenitis, in which submandibular glands usually appear enlarged, with heterogeneous and Iodinated contrast-induced sialadenitis: a review of the literature and sonographic findings in a clinical case increased echogenicity and with Doppler demonstrating hyperemia (especially in the acute phase). Particularly, of the four sonographic descriptions of iodide mumps available in the available scientific literature, three include the presence of central hyperemia in Doppler imaging (5,6,16) . In addition, Zhang found that, in computed tomography, the average density of the affected submandibular glands was lower than normal (20-40 HU), supporting the presence of edema (3) .…”

Section: Discussionmentioning

confidence: 99%

Iodinated contrast-induced sialadenitis: a review of the literature and sonographic findings in a clinical case

Lucarelli¹,

Perandini²,

Borsato³

et al. 2018

J Ultrason

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Swelling of the salivary glands, also known as iodide or iodine mumps, is a rare adverse reaction to administration of iodine, a component steadily present in current contrast media and in a variety of medications. We report and compare with published literature the clinical and sonographic findings in a case of iodide mumps that developed after the intravenous administration of iodine-based contrast media for a contrast-enhanced computed tomography scan. The exact pathogenesis is unknown to date: based on sonographic appearance, we support the hypothesis of an acute inflammatory condition elicited by iodine accumulation in the salivary glands. The emergency care practitioner needs to be confident with the clinical symptoms as well as the sonographic findings and therapeutic options to successfully manage this condition.

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“…There are also a few published case reports of pancreatic mumps and transient thyroid dysfunction; the aetiology of this is thought to be similar to iodide-induced sialadenitis. Facial nerve palsy, severe allergic vasculitis and erythaematous dermis are some of the other associated adverse events reported with iodinated dye 6. Our patient did not have any of these symptoms, including thyroid swelling, abdominal pain, back pain, and nausea and vomiting.…”

Section: Discussionmentioning

confidence: 52%

“…The probability of developing acute sialadenitis is directly proportional to serum iodide levels (>10 mg/100 mL) and inversely related to renal function 5. The injected dose of contrast does not usually result in sufficiently high iodide concentration, thus rarely causing sialadenitis in patients with normal renal function 6. However, with increasing renal dysfunction, the dye stays in systemic circulation for a longer time.…”

Section: Discussionmentioning

confidence: 99%

Iodide mumps following fistulogram in a haemodialysis patient

2016

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SUMMARYIodide mumps, or contrast-induced acute sialadenitis, is characterised by rapid, painless enlargement of the salivary glands, following the use of iodinated contrast dye. The underlying mechanism of this adverse reaction is not completely understood. It could be due to an idiosyncratic reaction or related to deposition of iodide in the ductal systems of the salivary glands causing blockage and inflammation. With increasing renal dysfunction, the elimination half-life of the iodinecontaining contrast dye gets prolonged. The course of iodine-induced sialadenitis is usually benign, and rapid resolution of symptoms is expected without definite treatment. The symptomatic management includes treatment with a parenteral non-steroidal antiinflammatory drug (NSAID), steroids and dialysis. However, the role of steroids has been found to be controversial in previously published case reports. Pancreatic mumps and transient thyroid dysfunction were also reported in patients following iodinated contrast administration; the aetiology of this is thought to be similar to iodide-induced sialadenitis. BACKGROUND

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Swelling of the submandibular glands after administration of low-osmolarity contrast agent: Ultrasound findings

Cited by 9 publications

References 4 publications

Characterization of Iodide-induced Sialadenitis: Meta-analysis of the Published Case Reports in the Medical Literature

Characterization of Iodide-induced Sialadenitis: Meta-analysis of the Published Case Reports in the Medical Literature

Iodinated contrast-induced sialadenitis: a review of the literature and sonographic findings in a clinical case

Iodide mumps following fistulogram in a haemodialysis patient

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