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Iodinated Contrast Induced Parotitis: A Case Report
S Nahar1, N A M Momenuzzaman, A Haque
1Dr Samsun Nahar, Associate Consultant (Cardiology), United Hospital Limited, Dhaka, Bangladesh;
Insights
Iodinated contrast agents used in coronary angiography can lead to parotitis, an inflammation of the salivary glands. This case report details a patient who developed bilateral parotitis after coronary angioplasty, which resolved with conservative management.
Area of Science:
- Cardiology
- Radiology
- Endocrinology
Background:
- Iodinated contrast media are frequently used in cardiovascular imaging procedures.
- Parotitis is a known, albeit rare, adverse reaction to iodinated contrast agents.
- This case highlights a potential complication following percutaneous coronary intervention (PCI).
Observation:
- A 70-year-old male with a history of hypertension, diabetes mellitus, and dyslipidemia presented with chest pain and shortness of breath.
- The patient had recently recovered from COVID-19 and had undergone PCI two years prior.
- Following coronary angiography, the patient developed bilateral parotitis.
Findings:
- Diagnostic workup revealed Non-ST-elevation myocardial infarction (NSTEMI) with impaired left ventricular function (ALVF).
- Electrocardiogram showed a bi-fascicular block, and echocardiogram indicated hypokinesis of the inferior and inferior-lateral walls.
- High-sensitivity Troponin I levels were elevated, while serum creatinine remained normal.
Implications:
- This case underscores the importance of recognizing parotitis as a potential adverse effect of iodinated contrast agents in patients undergoing cardiovascular procedures.
- Conservative management was effective in resolving the parotitis, suggesting a possible direct toxicity or idiosyncratic reaction to the contrast material.
- Awareness of this complication may aid in timely diagnosis and appropriate patient management, potentially preventing unnecessary interventions.
Abstract:
Contrast material containing Iodine can cause parotitis. Here we present A 70 year's old man admitted to United Hospital Limited, Gulshan, Dhaka, Bangladesh on 5th May 2021 with the complaints of chest pain and shortness of breath and he was diagnosed as NSTEMI with ALVF. He was Covid 19 positive two weeks back. He underwent PCI to LM to LAD, LCX and RCA two years back. He had hypertension, diabetes mellitus and dyslipidemia. He was taking dual antiplatelet, beta-blocker, ACE inhibitor, statin, diuretic and anti-diabetic medication. His physical examination findings were reasonably normal. An electrocardiogram revealed bi-fascicular block and echocardiogram showed inferior wall and basal segment of inferior-lateral wall were hypokinetic. His high sensitive Troponin I was raised and serum creatinine was normal. This case report contains a case of bilateral parotitis following coronary angioplasty, subsided with conservative management. Possible reasons may be the direct toxicity or idiosyncratic reaction of the iodinated contrast agent.
