Differential Diagnosis for Bilateral Parotid Swelling
Single Most Likely Diagnosis
- Sjögren's Syndrome: An autoimmune disorder that commonly presents with bilateral parotid swelling, along with dry eyes and dry mouth. It is a leading cause of bilateral parotid enlargement due to its direct involvement of the exocrine glands.
Other Likely Diagnoses
- Bulimia Nervosa: Recurrent vomiting can lead to bilateral parotid gland swelling due to increased salivation and glandular hypertrophy.
- Malnutrition: Deficiencies in nutrients can affect the parotid glands, leading to swelling.
- Alcoholism: Chronic alcohol abuse can cause parotid gland enlargement.
- HIV Infection: Bilateral parotid swelling can be seen in HIV patients, often associated with other systemic symptoms.
Do Not Miss Diagnoses
- Sarcoidosis: Although less common, sarcoidosis can cause bilateral parotid swelling and is critical to diagnose due to its potential for multi-organ involvement and serious complications if left untreated.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with parotid gland swelling, making it crucial for early detection and treatment.
- Tuberculosis: Parotid gland tuberculosis is rare but can occur, especially in endemic areas, and requires prompt diagnosis to initiate appropriate treatment.
Rare Diagnoses
- Heerfordt's Syndrome: A form of sarcoidosis that specifically affects the parotid gland, uvea, facial nerve, and sometimes the central nervous system.
- Mikulicz Disease: An autoimmune condition characterized by the enlargement of the salivary and lacrimal glands, which can mimic Sjögren's Syndrome but is distinct in its pathophysiology.
- Warthin's Tumor: A benign tumor of the parotid gland that can cause swelling, though it is typically unilateral.
- Parotid Gland Cysts: Congenital or acquired cysts within the parotid gland can cause swelling and may be bilateral in rare cases.