Capsule Summary
What is already known
Contrast-induced sialadenitis is a rare, nonallergic reaction characterized by acute swelling of the salivary glands after intravenous iodinated contrast administration. Symptoms generally appear within minutes to several days following exposure.
What is new in the current study
We present a case of bilateral submandibular gland swelling that developed one day after a contrast-enhanced computed tomography scan, without systemic or allergic manifestations. Imaging confirmed sialadenitis, and the patient recovered with supportive management alone.
A 51-year-old woman with a medical history of hypertension, irritable bowel syndrome, thalassemia minor, osteoarthritis, anxiety, and depression presented to the emergency department with mild dysphagia and submandibular swelling noted earlier that morning. The symptoms began one day after undergoing an outpatient computed tomography (CT) scan of the chest, abdomen, and pelvis with intravenous contrast for routine thalassemia monitoring. She denied fever, voice changes, tongue swelling, rash, or other allergic features. On examination, she had firm, immobile, symmetric bilateral submandibular gland swelling without sublingual fullness, erythema, or dental abnormalities. Renal function was within normal limits.
CT imaging showed bilateral submandibular gland enlargement consistent with sialadenitis (
Fig. 1). She was diagnosed with contrast-induced sialadenitis (“iodine mumps”), a rare, nonallergic, self-limiting condition first described in 1956 [
1]. The proposed mechanism involves accumulation of contrast material in the salivary glands rather than an immune-mediated reaction [
2,
3]. Symptoms typically resolve within a few days with supportive care [
4,
5]. The patient remained clinically stable in the emergency department and was discharged with complete recovery.
NOTES
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Ethics statement
Informed consent for publication of the research details and clinical images was obtained from the patient.
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Author contributions
Conceptualization: all authors; Investigation: all authors; Project administration: all authors; Supervision: MG; Visualization: all authors; Writing–original draft: all authors; Writing–review & editing: all authors. All authors read and approved the final manuscript.
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Conflicts of interest
Michael Gottlieb is an associate editor of this journal, but was not involved in the peer reviewer selection, evaluation, or decision process of this article. The authors have no other conflicts of interest to declare.
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Funding
The authors received no financial support for this study.
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Data availability
Data sharing is not applicable as no new data were created or analyzed in this study.
Fig. 1.Bilateral submandibular gland sialadenitis (arrows) seen on computed tomography in (A) coronal, (B) sagittal, and (C) axial views.
REFERENCES
- 1. Miller J, Sussman RM. Iodide mumps after intravenous urography. N Engl J Med 1956;255:433-4.
- 2. Zhang G, Li Y, Zhang R, et al. Acute submandibular swelling complicating arteriography with iodide contrast: a case report and literature review. Medicine (Baltimore) 2015;94:e1380.
- 3. Zhang G, Li T, Wang H, Liu J. The pathogenesis of iodide mumps: a case report. Medicine (Baltimore) 2017;96:e8881.
- 4. Lucarelli A, Perandini S, Borsato A, Strazimiri E, Montemezzi S. Iodinated contrast-induced sialadenitis: a review of the literature and sonographic findings in a clinical case. J Ultrason 2018;18:359-64.
- 5. Jiao A, Farsad K, McVinnie DW, Jahangiri Y, Morrison JJ. Characterization of iodide-induced sialadenitis: meta-analysis of the published case reports in the medical literature. Acad Radiol 2020;27:428-35.
Citations
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