Heerfordt-Waldenström syndrome is a rare subacute variant of sarcoidosis, characterized by enlargement of the parotid or salivary glands, facial nerve paralysis. Images in Clinical Medicine from The New England Journal of Medicine — Heerfordt’s Syndrome, or Uveoparotid Fever. Heerfordt’s syndrome is a rare manifestation of sarcoidosis characterized by the presence of facial nerve palsy, parotid gland enlargement.

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The condition was first described in by Danish ophthalmologist Christian Frederick Heerfordt, for whom the syndrome is now named. The patient was negative bilaterally for eherfordt reflex. Articles Cases Courses Quiz. You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. He was admitted to the Department of Dermatology in our hospital in August, because of worsening swelling of his right eyelid.

Heerfordt syndrome | QJM: An International Journal of Medicine | Oxford Academic

One year later, left peripheral facial paralysis was diagnosed, and the previous treatment was successfully instituted. The patient’s ophthalmologic exam was notable for impaired corneal sensation, punctate epithelial erosions in both eyes, and no overt flare or leukocytes seen on slit lamp exam.

PET showed hypermetabolic activity in the bilateral hilar lymph nodes, mediastinal lymph nodes, lung, spleen, and myocardium Figure 5. Although uveitis was not detected in the ophthalmologic examination, biopsy specimens from the right eyelid and the lymph node in the left thigh revealed noncaseating epithelioid cell granuloma and a diagnosis of sarcoidosis was made histologically Figure 3.


However, due to the delay in the histological confirmation of sarcoidosis, deterioration of the underlying cardiac sarcoidosis resulted in heart failure. Oral corticosteroids represent the first line treatment option. Edit article Share article View revision history.

Fine-needle aspiration of a left preauricular lymph node revealed multinucleated giant cells and noncaseating granulomas consistent with granulomatous lymphangitis Figure 2. The simultaneous presence of all symptoms represents the complete form of this syndrome, with the complete form constituting 0. CT of the neck soft tissues demonstrating prominent cervical lymphadenopathy.

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Presence of multinucleated cells in the granuloma right heercordt, hematoxylin and eosin, X Heerfordt syndrome with unilateral facial nerve palsy: This holds also true for the single symptoms facial nerve palsy and anterior uveitis 2.

Sarcoidosis is a granulomatous disease of ayndrome etiology, which commonly presents with cough, dyspnea, chest pain, fever, weight loss, arthralgias, and erythema nodosum. Granulomas with a peripheral lymphocyte deficit are found in the anatomic pathology of affected organs. Anterior uveitis classically presents with infected conjunctiva, blurred vision, or eye pain Magnetic resonance imaging with gadolinium enhancement revealed no lesions in her brain.


She had been previously diagnosed with uveitis and bilateral hilar lymphadenopathy. The patient did not complain of impaired taste.

Heerfordt syndrome | Radiology Reference Article |

The principal vascular causes of unilateral facial weakness are ischemic stroke and intraparenchymal hemorrhage involving the cranial nerve VII syndromd. Treatment with a high-dose steroid improved her parotid gland enlargement, facial palsy, and anterior uveitis.

Journal List An Bras Dermatol v. The facial nerve palsy is associated with epineural granulomas and perineural inflammatory infiltrates of cranial heerfordr VII Find articles by Neusa Yuriko Sakai Valente.

The Heerfordt-Waldenström syndrome as an initial presentation of sarcoidosis

Tuberculosis, herrfordt granulomatosis, and sarcoidosis are granulomatous diseases that cause unilateral facial palsy. This patient’s blurred vision and eye pain were thought to be related to uveitis. Etiologies of facial nerve palsy. The constellation of symptoms along with blood samples and biopsy usually allows the diagnosis. However, the patient required urgent hospitalization for heart failure after 2 months.