Acute salivary gland inflammation associated with systemic lupus erythematosus.

The parotid gland may enlarge during the course of systemic lupus erythematosus (SLE). Shearn and Pirofsky (1952) were the first to draw attention to this association while studying a group of 34 patients who had systemic lupus erythematosus. They discovered sialoadenitis characterized by chronic, nonsuppurative inflammation unilaterally in one and bilaterally in two patients. Morgan (1954) reported systemic lupus erythematosus in a patient with the Sjogren-Mikulicz syndrome, and Harvey, Shulman, Tumulty, Conley, and Schoenrich (1954) described a 13-year-old Negro girl who developed chronic parotid swelling and eventually died from classical lupus erythematosus. Heaton (1959) claimed that most of his 28 cases of Sjogren's syndrome had other findings suggestive of SLE including ten with positive LE preparations. In his text, Dubois (1966) noted six of 520 cases with SLE (1 -1 per cent.) as having extreme enlargement of the parotid, submaxillary, and/or lacrimal glands. Although none of these cases was acute, one, a 19-year-old Negro girl, was admitted because of parotid swelling of only 4 weeks' duration associated with a flare of her generalized disease. All other authors (Futcher, 1959; Bain, 1960) have likewise reported subacute or chronic salivary gland enlargement not parallelling systemic disease activity. As a matter offact, Heaton (1959) concluded that Sjogren's syndrome is a chronic, relatively benign form of systemic lupus erythematosus. We report three cases in which acute inflammation of the salivary glands reflected lupus activity.