A Case of Mikulicz's Syndrome Associated with Sarcoidosis

Abstract

A 29-year-old woman with symmetrical bilateral swelling of the parotid, submandibular, and lacrimal glands—also called Mikulicz's symptoms—showed skin rash and pedal erythema. Serum IgG4 was within the normal range but serum ACE and lysozome were elevated. Incisional biopsy of the parotid glands and histopathological examination indicated sarcoidosis. This was complicated by uveitis and a low-grade fever. No facial nerve palsy was observed. Based on these findings, the definitive diagnosis was Mikulicz's syndrome associated with sarcoidosis. An alternative diagnosis was incomplete Heerfordt syndrome. The administration of steroid hormones, caused parotid, submandibular, and lacrimal glands swelling to disappear.