A 25-year-old female with history of recurrent oral ulcers and bilateral painless enlargement of parotid glands is found to have hypercalcaemia. The most likely diagnosis is:
- A Sjögren's syndrome
- B Sarcoidosis (Heerfordt syndrome) ✓
- C Mikulicz disease (IgG4-related)
- D Alcoholic parotitis
Correct answer: B. Sarcoidosis (Heerfordt syndrome)
Explanation
Heerfordt syndrome (uveoparotid fever) is a manifestation of sarcoidosis characterised by parotid enlargement, uveitis, facial palsy and fever. Sarcoidosis causes hypercalcaemia through 1-alpha hydroxylase activity of granuloma macrophages activating vitamin D. Sjögren's syndrome causes sicca symptoms and positive anti-Ro/La antibodies. IgG4-related Mikulicz disease presents with bilateral salivary/lacrimal gland enlargement but typically without hypercalcaemia. Alcoholic parotitis is bilateral but related to nutritional deficiency.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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