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Bilateral Parotid Gland Enlargement and Hyperlipoproteinemia FREE

H. Benfer Kaltreider, MD; Norman Talal, MD
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JAMA. 1969;210(11):2067-2070. doi:10.1001/jama.1969.03160370051010
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Sjögren's syndrome was the initial diagnosis of the physicians who referred five patients with bilateral, noninflammatory parotid gland enlargement. This diagnosis was not confirmed in any case. All five patients had elevated plasma triglyceride concentrations and mild diastolic hypertension. Increased intake of alcoholic beverages, abnormal glucose tolerance, and moderate obesity were frequently present. Massive replacement of the parotid gland tissue by fat was observed in two biopsy specimens. Restriction of calories, alcoholic beverages, and the percent of calories from carbohydrate resulted in regression of parotid gland size in three patients observed for more than three months. A modest short-term reduction in size of the parotid gland occurred in one other patient over a five-week period. Hypertriglyceridemia was also ameliorated by this dietary regimen.

REFERENCES

Sprinkle, P.M., and Yarington, C.T., Jr.:  Disease of the Salivary Glands and Benign Lymphoepithelial Lesion , Southern Med J 61:971-974 ( (Sept) ) 1968;.
Gilchrist, R.K., and McAndrew, J.R.:  Surgical Parotitis , Arch Surg 76:863-867 ( (June) ) 1958;.
Yarington, C.T., Jr.; Sprinkle, P.M.; and Gensler, S.:  Granulomatous Parotitis , W Virginia Med J 63:440-443 ( (Dec) ) 1967;.
Bloch, K.J., et al:  Sjögren's Syndrome: A Clinical, Pathological, and Serological Study of 62 Cases , Medicine 44:187-231 ( (May) ) 1965;.
Morgan, W.S., and Castleman, B.:  A Clinicopathologic Study of "Mikulicz's Disease," Amer J Path 29:471-503 ( (May) -June) 1953;
Davidson, D.; Leibel, B.S.; and Berris, B.:  Asymptomatic Parotid Gland Enlargement in Diabetes Mellitus , Ann Intern Med 70:31-38 ( (Jan) ) 1969;.
Phillips, L.G., and Honolulu, T.H.:  Parotid Swelling Associated With Lactation: With the Report of a Case , Amer J Obstet Gynec 22:434-438 ( (Sept) ) 1931;.
Sandstead, H.R.; Koehn, C.J.; and Sessoms, SM.:  Enlargement of the Parotid Gland in Malnutrition , Amer J Clin Mutr 3:198-214 ( (May) -June) 1955;.
Katsilambros, L.:  Asymptomatic Enlargement of the Parotid Glands , JAMA 178:513-514 ( (Nov 4) ) 1961;.
Hemenway, W.G., and Allen, G.W.:  Chronic Enlargement of the Parotid Gland: Hypertrophy and Fatty Infiltration , Laryngoscope 69:1508-1523 ( (Dec) ) 1959;.
Wolfe, S.J.; Summerskill, W.H.J.; and Davidson, C.S.:  Parotid Swelling, Alcoholism and Cirrhosis , New Eng J Med 256:491-495 ( (March) ) 1957;.
Duggan, J.J., and Rothbell, E.N.:  Asymptomatic Enlargement of the Parotid Glands , New Eng J Med 257:1262-1267 ( (Dec) ) 1957;.
Silverman, M., and Perkins, R.L.:  Bilateral Parotid Enlargement and Starch Ingestion , Ann Intern Med 64:842-846 ( (April) ) 1966;.
Seltzer, C.C.:  Some Re-Evaluation of the Build and Blood Pressure Study, 1959 As Related to Ponderal Index, Somatotype, and Mortality , New Eng J Med 274:254-259 ( (Feb) ) 1966;.
Talal, N.; Asofsky, R.; and Lightbody, P.:  Immunoglobulin Synthesis by Salivary Gland Lymphoid Cells in Sjögren's Syndrome , Arthritis Rheum 12:338-339 ( (June) ) 1969;.
Fredrickson, D.S.; Levy, R.I.; and Lees, RS.:  Fat Transport in Lipoproteins: An Integrated Approach to Mechanisms and Disorders , New Eng J Med 276:94-103; 148-156; 273-281 ( (Jan) Feb) 1967;.
Jones, D.P., et al:  Effects of Ethanol on Plasma Lipids in Man , J Lab Clin Med 62:675-682 ( (Oct) ) 1963;.
Levy, R.I., and Glueck, C.J.:  Hypertriglyceridemia, Diabetes Mellitus, and Coronary Vessel Disease , Arch Intern Med 123:220-228 ( (March) ) 1969;.

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Sprinkle, P.M., and Yarington, C.T., Jr.:  Disease of the Salivary Glands and Benign Lymphoepithelial Lesion , Southern Med J 61:971-974 ( (Sept) ) 1968;.
Gilchrist, R.K., and McAndrew, J.R.:  Surgical Parotitis , Arch Surg 76:863-867 ( (June) ) 1958;.
Yarington, C.T., Jr.; Sprinkle, P.M.; and Gensler, S.:  Granulomatous Parotitis , W Virginia Med J 63:440-443 ( (Dec) ) 1967;.
Bloch, K.J., et al:  Sjögren's Syndrome: A Clinical, Pathological, and Serological Study of 62 Cases , Medicine 44:187-231 ( (May) ) 1965;.
Morgan, W.S., and Castleman, B.:  A Clinicopathologic Study of "Mikulicz's Disease," Amer J Path 29:471-503 ( (May) -June) 1953;
Davidson, D.; Leibel, B.S.; and Berris, B.:  Asymptomatic Parotid Gland Enlargement in Diabetes Mellitus , Ann Intern Med 70:31-38 ( (Jan) ) 1969;.
Phillips, L.G., and Honolulu, T.H.:  Parotid Swelling Associated With Lactation: With the Report of a Case , Amer J Obstet Gynec 22:434-438 ( (Sept) ) 1931;.
Sandstead, H.R.; Koehn, C.J.; and Sessoms, SM.:  Enlargement of the Parotid Gland in Malnutrition , Amer J Clin Mutr 3:198-214 ( (May) -June) 1955;.
Katsilambros, L.:  Asymptomatic Enlargement of the Parotid Glands , JAMA 178:513-514 ( (Nov 4) ) 1961;.
Hemenway, W.G., and Allen, G.W.:  Chronic Enlargement of the Parotid Gland: Hypertrophy and Fatty Infiltration , Laryngoscope 69:1508-1523 ( (Dec) ) 1959;.
Wolfe, S.J.; Summerskill, W.H.J.; and Davidson, C.S.:  Parotid Swelling, Alcoholism and Cirrhosis , New Eng J Med 256:491-495 ( (March) ) 1957;.
Duggan, J.J., and Rothbell, E.N.:  Asymptomatic Enlargement of the Parotid Glands , New Eng J Med 257:1262-1267 ( (Dec) ) 1957;.
Silverman, M., and Perkins, R.L.:  Bilateral Parotid Enlargement and Starch Ingestion , Ann Intern Med 64:842-846 ( (April) ) 1966;.
Seltzer, C.C.:  Some Re-Evaluation of the Build and Blood Pressure Study, 1959 As Related to Ponderal Index, Somatotype, and Mortality , New Eng J Med 274:254-259 ( (Feb) ) 1966;.
Talal, N.; Asofsky, R.; and Lightbody, P.:  Immunoglobulin Synthesis by Salivary Gland Lymphoid Cells in Sjögren's Syndrome , Arthritis Rheum 12:338-339 ( (June) ) 1969;.
Fredrickson, D.S.; Levy, R.I.; and Lees, RS.:  Fat Transport in Lipoproteins: An Integrated Approach to Mechanisms and Disorders , New Eng J Med 276:94-103; 148-156; 273-281 ( (Jan) Feb) 1967;.
Jones, D.P., et al:  Effects of Ethanol on Plasma Lipids in Man , J Lab Clin Med 62:675-682 ( (Oct) ) 1963;.
Levy, R.I., and Glueck, C.J.:  Hypertriglyceridemia, Diabetes Mellitus, and Coronary Vessel Disease , Arch Intern Med 123:220-228 ( (March) ) 1969;.
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