The pathogenesis of iodide mumps: A case report

Area of Science:

• Radiology
• Endocrinology
• Pathology

Background:

• Iodide mumps is an uncommon salivary gland enlargement following contrast agent administration.
• Its pathogenesis remains unclear, with theories including idiosyncratic reactions, iodine toxicity, or impaired iodine excretion.
• This report focuses on a specific case to elucidate the condition's presentation and underlying mechanisms.

Observation:

• A 66-year-old male developed bilateral parotid enlargement five hours after digital subtraction angiography (DSA) using iodixanol contrast.
• The patient had no prior contrast allergy history, normal renal function, and presented with swelling but no pain or fever.
• Initial diagnosis considered iodide mumps due to the characteristic rapid, painless salivary gland enlargement.

Findings:

• Diffusion magnetic resonance imaging (dMRI) revealed no significant signal abnormalities or changes in the apparent diffusion coefficient (ADC).
• Intravenous dexamethasone was administered, leading to parotid gland shrinkage within 20 hours.
• Complete resolution of parotid swelling was observed within four days post-procedure.

Implications:

• The lack of dMRI abnormalities suggests vasogenic edema as a potential key factor in iodide mumps pathogenesis.
• This case highlights the importance of considering iodide mumps in patients with salivary gland swelling post-contrast.
• Further research into the role of vasogenic edema could inform diagnostic and therapeutic strategies for iodide mumps.