Iodine-Induced Sialadenitis Requiring Intubation After Intracranial Venous Sinus Stenting: A Case Report

Area of Science:

• Radiology
• Endocrinology
• Otolaryngology

Background:

• Iodine-induced sialadenitis (iodine-induced mumps) is a rare condition characterized by acute salivary gland swelling following iodine-containing compound administration.
• First described in 1956, over 100 cases have been reported, most commonly after iodinated contrast media use.
• The exact pathophysiology remains unclear, but it mimics mumps virus effects.

Purpose of the Study:

• To report a case of iodine-induced sialadenitis with severe respiratory distress.
• To emphasize the importance of recognizing airway compromise as a potential complication.
• To highlight the need for clinician awareness and safer imaging practices.

Main Methods:

• A case report of a 37-year-old woman who developed symptoms after a cervical-cerebral angiogram and venous sinus stenting.
• Clinical observation of painful, unilateral salivary gland swelling and respiratory distress.
• Treatment with corticosteroids and supportive care, followed by allergy testing.

Main Results:

• The patient experienced acute, painful swelling of parotid and submandibular glands, progressing to respiratory distress requiring intubation.
• Corticosteroids and supportive care led to complete symptom resolution.
• Allergy testing revealed hypersensitivity to iopamidol but not iohexol.

Conclusions:

• Iodine-induced sialadenitis can be a rare but life-threatening complication, even without renal impairment.
• Airway compromise is a serious concern that necessitates prompt recognition.
• Increased clinical suspicion and awareness are crucial for managing patients with acute salivary gland swelling post-contrast exposure.