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Common Characteristics and Clinical Management Recommendations for Juvenile Recurrent Parotitis: A 10-Year Tertiary
Ezer Benaim1, Timothy Fan1, Anwesh Dash1
1Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Insights
Juvenile recurrent parotitis (JRP) most often affects young Black males and may be linked to atopy and excess weight. Management should prioritize less invasive methods, with sialendoscopy effective for severe cases.
Area of Science:
- Pediatric Otolaryngology
- Rare Diseases
- Inflammatory Conditions
Background:
- Juvenile recurrent parotitis (JRP) is a rare condition impacting children's development and quality of life.
- Understanding JRP demographics, characteristics, and treatment outcomes is crucial for effective management.
Purpose of the Study:
- To describe the demographics, clinical features, and treatment results of JRP.
- To provide evidence-based recommendations for managing JRP.
Main Methods:
- Retrospective review of medical records, imaging, and lab data from 41 pediatric patients (8 months to 16 years) over 10 years.
- Analysis of patient demographics, treatment modalities (antibiotics, sialendoscopy), imaging findings (CT, ultrasound), and laboratory results (amylase, CRP).
Main Results:
- JRP predominantly affected Black males aged 2-8 years.
- Sialendoscopy was used in 42% of patients, with over 75% achieving no recurrence after 3 procedures.
- Atopy (61%) and excess weight (42%) were associated with JRP, particularly severe cases.
Conclusions:
- Initial JRP management should involve conservative measures like analgesics and ultrasonography.
- Clindamycin is a recommended initial antibiotic, while sialendoscopy can manage severe recurrences.
- Addressing comorbidities such as atopy and obesity is vital for optimizing JRP patient health.
Objective:
Juvenile recurrent parotitis (JRP) is a rare disease that may adversely affect normal development and quality of life. The objective of this study was to report on the demographics, characteristics, and treatment outcomes of JRP and to offer evidence-based management recommendations.
Study Design:
Retrospective review.
Setting:
A single tertiary care pediatric teaching hospital.
Methods:
Medical records, imaging studies, and laboratory findings over a 10-year period were retrospectively collected and reviewed, resulting in 41 patients with JRP between the ages of 8 months and 16 years.
Results:
Black males aged 2 to 8 years were most commonly affected by JRP. Overall, 18 (44%) patients received ≥3 antibiotics, and 17 (42%) underwent sialendoscopy for treatment. Over 75% of patients had no JRP recurrences after 3 sialendoscopies. The most common imaging approach was computed tomography (42%), and the most frequent laboratory results were elevated amylase (83%) and C-reactive protein (82%). Atopy (61%) and excess weight (42%) were routinely associated with JRP, especially in severe cases.
Conclusion:
JRP workup and treatment plans should begin with the least burdening modalities, including over-the-counter analgesics, minimal laboratory studies in the acute phase, and ultrasonography over computed tomography. Clindamycin is an effective initial antibiotic of choice, and severe recurrences may be controlled with sialendoscopy. Optimizing the health of patients with JRP includes managing comorbidities, especially of atopic and overweight origins, which are associated with more severe cases.
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