1/11. Revisiting a controversial surgical technique in the treatment of bulimic parotid hypertrophy.bulimia nervosa is a recognized cause of bilateral parotid gland enlargement that may not be appreciated by most otolaryngologists. Classically the parotid enlargement is transient but may be permanent and spectacular. Our review of the published literature revealed only 2 previous cases that have been considered for superficial parotidectomy, along with much debate as to the efficacy of such treatments. Neither case reported any postoperative complications. We present a bulimic patient who developed bilateral postoperative fistulae after surgery for marked, permanent enlargement of her parotids. Both fistulas closed spontaneously. However, a year later she has relapsed into bulimic behavior and developed further parotid gland hypertrophy. Because of this complication, we believe surgery has no role to play in the overall treatment of these severe cases unless the patients show a prolonged cessation of their bulimic behavior.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/11. Diagnosing bulimia nervosa with parotid gland swelling.BACKGROUND: The authors describe bulimia nervosa, or BN, and its effect on the parotid gland. The associated asymptomatic bilaterally enlarged parotid glands often present a diagnostic dilemma. CASE DESCRIPTION: The authors present a case of a 22-year-old woman with BN who had bilateral parotid gland swelling, serum electrolyte alteration and no dental stigmata. Her principal concern was the associated cosmetic deformity. CLINICAL IMPLICATIONS: Because patients with BN who have parotid gland swelling usually are secretive about their purging, the diagnosis may be confirmed by conducting a clinical examination and a serum electrolyte study. Prompt diagnosis can avoid serious medical complications.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
3/11. Anorexia/bulimia-related sialadenosis of palatal minor salivary glands.In patients affected by alimentary disorders sialadenosis is frequently observed. This non-inflammatory condition is described to affect major salivary glands, leading to the characteristic parotid and/or submandibular swelling. Thus fine-needle aspiration cytology or parotid open biopsy are generally required to diagnose histologically the disorder. We report the case of a 28-year-old patient affected by bulimia/anorexia nervosa who presented, in addition to parotid enlargement, a bilateral symmetric painless soft swelling of the hard palate. The lesion was biopsied and histopathological examination showed the classical features of sialadenosis. To our knowledge, this is the first case of sialadenosis affecting palatal minor salivary glands. It underlines that when sialadenosis is clinically suspected, clinicians could check also patients' oral cavity for minor salivary glands involvement, in order to potentially avoid invasive extra-oral procedures and to easily confirm diagnosis with an intra-oral biopsy.- - - - - - - - - - ranking = 3.5keywords = gland (Clic here for more details about this article) |
4/11. bulimia nervosa and acne may be related: a case report.Acne is a very common, often cosmetically disfiguring, cutaneous condition of adolescence that is associated with increased sebaceous gland activity. We present the case of a patient with bulimia who reported that the negative effect of acne on her appearance increased her body image concerns and exacerbated her eating disorder. Improvement of the acne was associated with a significant improvement in her eating disorder. Eating disordered patients may go on restrictive diets in order to control their acne since levels of androgens, which are one of the primary stimulants of sebaceous gland activity, are lower in starvation. As a significant number of adolescents with eating disorders also develop acne, it is important for the clinician to be aware of this previously unreported association between acne and eating disorders, and to evaluate the impact of acne upon the patient's body image and eating behaviour.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
5/11. Sialosis and necrotising sialometaplasia in bulimia; a case report.Salivary gland involvement, particularly salivary gland enlargement (sialosis), is a recognised complication in bulimia. We report the rare association of sialosis and necrotising sialometaplasia with bulimia in the same patient. The association of sialosis and necrotising sialometaplasia in the same patient with bulimia has been reported previously in two patients and may be coincidental, but the appearance in this additional patient suggests it may be prudent to explore this further.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
6/11. Necrotizing sialometaplasia associated with bulimia: case report and literature review.Necrotizing sialometaplasia (NSM) is a self-limiting disorder affecting mainly the minor salivary glands. The significance of NSM resides in its clinical and histopathological resemblance to carcinoma. Few cases of NSM associated with eating disorders have been reported to date. We present here the clinical features and histomorphology of an additional case of bulimia-associated NSM closely mimicking an invasive carcinoma. A high index of suspicion and good communication between clinician and pathologist are essential in recognizing this entity and preventing unnecessary surgical therapy.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
7/11. iodine-induced subacute thyroiditis with thyrotoxicosis presenting as fever of unknown origin.A 26-year-old woman with features of bulimia nervosa presented with fever of unknown origin, hepatomegaly, marked leukocytosis, and increased erythrocyte sedimentation rate. Following prolonged observation, slight tenderness over the thyroid gland and signs of thyrotoxicosis occurred. A thyroid scan demonstrated no isotope uptake and the patient admitted abusing an organic iodine preparation in order to control her weight. The diagnosis of iodine-induced subacute thyroiditis with thyrotoxicosis was, therefore, considered. A brief course of low-dose steroids normalized both thyroid function and hematological parameters. On followup evaluation, urinary iodine excretion and thyroid function tests were normal.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
8/11. Enlargement of salivary glands in bulimia.We report a unusual case of bulimia nervosa with bilateral swelling of parotid and submandibular glands as the only symptom of the underlying behavioural disorder. Histologically, sialadenosis was diagnosed in a parotid biopsy. The parotomegaly in bulimia may be a diagnostic primer as these patients often deny their eating disorder. B-scan ultrasonography is an important diagnostic tool to assess the nature of the parotid enlargement. Hyperamylasaemia occurs commonly in bulimic patients and may help to confirm the diagnosis. All patients with suspected bulimia should have a thorough medical history and physical examination to rule out other aetiologies of asymptomatic parotid swelling. As the enlargement is usually transient surgical intervention is only rarely required.- - - - - - - - - - ranking = 2.5keywords = gland (Clic here for more details about this article) |
9/11. Bilateral parotid enlargement as a presenting feature of bulimia nervosa in a post-adolescent male.An unusual case of bulimia nervosa in a post-adolescent male is reported. The clinical presentation was one of painless parotid swelling of 3 years duration with marked weight loss and underlying metabolic alkalosis. The diagnostic significance of parotid salivary gland swellings is discussed.- - - - - - - - - - ranking = 0.5keywords = gland (Clic here for more details about this article) |
10/11. Sialadenosis in bulimia. A new treatment.OBJECTIVE--To see whether a cholinomimetic medication would help resolve the parotid gland enlargement associated with self-induced vomiting in bulimic patients. SETTING/DESIGN--The medication was administered on an inpatient eating disorder unit to bulimic patients with refractory sialadenosis. INTERVENTION--pilocarpine hydrochloride drops were administered orally at a dosage of 1.25 to 5.0 mg/d until the parotid gland enlargement was significantly reduced. RESULTS--There was a marked diminution in the size of the parotid gland enlargement. CONCLUSION--pilocarpine has proved to be beneficial in the treatment of sialadenosis in bulimic patients.- - - - - - - - - - ranking = 1.5keywords = gland (Clic here for more details about this article) |
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