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tional deficits may be even greater in pa- cines as an MMR vaccine. Once infected, arthritis: Utility to evaluate and predict response
tients with alcohol-related liver disease. In the disease is generally self-limiting and to treatment. Modern Rheumatology, 28(2), 300–
11
the acute stage of AHC, there is acinar hy- benign and treated with palliative care treat- 307. https://doi-org.citytech.ezproxy.cuny.edu/10.
pertrophy, but when the disease progresses ing the symptoms as needed. Most MMR 1080/14397595.2017.1349234.
8. Qin B, Wang J, Yang Z, et al. Epidemiology
and becomes chronic, the deficient hepatic vaccines are given to children at the ages of of primary Sjogren’s syndrome: a systemat-
function causes a disturbance in fat metab- one year to 15 months, with a second dose ic review and meta-analysis. Ann Rheum Dis
olism. As a consequence, the fat infiltration often given at any age after the first vaccine 2015;74(11):1983-9.
is the main cause of parotid enlargement. through 13 years. Complications with the 9. Mossel, E., van Ginkel, M. S., Haacke, E. A.,
12
vaccine are rare and generally consist of fe- Arends, S., Liefers, S. C., Delli, K., van Nimwe-
Alcoholism can be diagnosed by a medical ver and rash or reaction at the vaccine site. gen, J. F., Stel, A. J., Spijkervet, F. K. L., Vissink,
A., van der Vegt, B., Kroese, F. G. M., & Bootsma,
doctor. Behavioral treatments, such as coun- Recovery takes about two weeks. Mumps H. (2022). Histopathology, salivary flow and ul-
seling or therapy, medications and group outbreaks are not uncommon and the most trasonography of the parotid gland: three comple-
meetings are treatment options for alcohol- recent outbreak in the United States was in mentary measurements in primary Sjögren’s syn-
ism. Xerostomia can be treated with xylitol 2006 with approximately 5800 cases, pre- drome. Rheumatology (Oxford, England), 61(6),
products, artificial saliva gels and topicals, dominantly among college age students. 2472–2482. https://doi-org.citytech.ezproxy.cuny.
sipping water or chewing sugarless gum to edu/10.1093/rheumatology/keab781.
10. Adhikari R, Soni A. Submandibular Sialad-
stimulate salivary flow. Conclusion enitis and Sialadenosis. [Updated 2022 Aug 8].
Although there are other infectious diseases In: StatPearls [Internet]. Treasure Island (FL):
Mumps which can affect the parotid gland these four StatPearls Publishing; 2023 Jan-. Available from:
Mumps is a common childhood infection conditions are typically associated with pa- https://www.ncbi.nlm.nih.gov/books/NBK562211/
caused by the mumps virus. It is most often rotid gland swellings. It is imperative to de- 11. Guggenheimer, J., Close, J. M., & Eghtesad,
seen in children, however, since the advent termine which of the causes is most likely the B. (2009). Sialadenosis in patients with advanced
liver disease. Head and neck pathology, 3(2), 100–
of the MMR vaccine (virus) it is seen with instigating factor with a patient presenting 105. https://doi.org/10.1007/s12105-009-0113-6.
less frequency in vaccinated children in de- with parotid gland swelling and to consider 12. Bohl, L., Merlo, C., Carda, C., Gómez de
veloped countries. The incidence of mumps factors such as age, degree of onset (rapid Ferraris, M. E., & Carranza, M. (2008). Morpho-
has shown a dramatic decrease since the in- or slow), if the patient should be worked up metric analysis of the parotid gland affected by

troduction of the mumps vaccine in 1967. for a systemic disease like HIV or Sjögren’s alcoholic sialosis. Journal of Oral Pathology &
13
Medicine : Official Publication of the Interna-
Prior to the vaccine 50% of children de- syndrome, or they should be referred to a tional Association of Oral Pathologists and the
veloped mumps. Currently there are about physician or therapist specializing in treating American Academy of Oral Pathology, 37(8),
1500 cases in the United States annually, patients with a history of alcohol abuse. 499–503. https://doi-org.citytech.ezproxy.cuny.
which is down from about 150,000. edu/10.1111/j.1600-0714.2008.00648.x
References 13. Hviid, A., Rubin, S., & Mühlemann, K.
The pathognomonic presentation of mumps 1. Gualtierotti, R., Marzano, A., Spadari, F., & (2008). Mumps. The Lancet, 371(9616), 932-944.
is bilateral swellings of the parotid gland; Cugno, M. (2018). Main Oral Manifestations in
however other glands, including the sub- Immune-Mediated and Inflammatory Rheumatic Cristina Masino, RDH,
mandibular glands, can be affected as well. Diseases. Journal of Clinical Medicine, 8(1), BS, MBA, is a lecturer
21. https://doi.org/10.3390/jcm8010021.
If an older person is exposed to the virus 2. Chason HM, Downs BW. Anatomy, Head in the Dental Hygiene
without the protection of a vaccine, the and Neck, Parotid Gland. [Updated 2022 Oct Department at New York
possibility of deafness and pancreatitis can 24]. In: StatPearls [Internet]. Treasure Island City College of Technol-
be possible sequelae. In younger patients (FL): StatPearls Publishing; 2023 Jan-. Avail- ogy in Brooklyn. She has
common complications include aseptic able from: https://www.ncbi.nlm.nih.gov/books/ worked in the dental field
meningitis and encephalitis along with or- NBK534225/ for 22 years and works as
3. Middleton, Hayden PA-C, MS; Strelow,
chitis and oophoritis. The mumps virus Brittany DMSc, PA-C, MS. Pleomorphic ad- a clinical dental hygienist on Long Island,
NY. She can be reached at: Cristina.Masi-
(paramyxovirus; RNA virus) is also called enoma of the parotid gland. JAAPA 35(9):p no212@citytech.cuny.edu.
benign viral parotitis. Mumps is transmitted 54-56, September 2022. | DOI: 10.1097/01.
in saliva and respiratory droplets and the in- JAA.0000854504.04227.cf. Dr. Gwen Cohen Brown
cubation period is 15-24 days. The most 4. Boyd, M. A., Boffito, M., Castagna, A., & is a Full Professor in
13
typical presentation for mumps is a painful Estrada, V. (2019). Rapid initiation of antiretro- the Dental Hygiene
viral therapy at HIV diagnosis: definition, pro-
swelling of the parotid glands which is seen cess, knowledge gaps. HIV Medicine, 20 Suppl Department, a licensed
in 60 -70% of patients with mumps and 95% 1, 3–11. https://doi-org.citytech.ezproxy.cuny. dentist in New York
of patients who are symptomatic. Definitive edu/10.1111/hiv.12708. State, and a Fellow in
diagnosis is currently done via RT-PCR 5. Wu, B., Ngo, R., & Petersson, F. (2014). the Academy of Oral and
directly on the clinical specimen targeting Cystic lymphoid hyperplasia of the pa- Maxillofacial Pathology.
rotid gland as the initial manifestation of
the detection of the mumps gene itself. Ap- HIV infection. Singapore Medical Journal, Dr. Brown is the Dental Expert for
proximately one-third of all cases are sub- 55(1), e12–e16. https://doi-org.citytech.ezproxy. WebMD and faculty at the NY/NJ AIDS
clinical, with 60% presenting bilaterally cuny.edu/10.11622/smedj.2014010. Education and Training Center. She is a
member of the Dental Standards of Care
initially though the other side often swells 6. Sekikawa Y, Hongo I. HIV-associated be- Committee charged with writing current
after a few days. Some people experience nign lymphoepithelial cysts of the parot- HIV Clinical Guidelines Program for the
no symptoms. When symptoms occur, they id glands confirmed by HIV-1 p24 antigen NYSDOH/AIDS Institute with Johns Hop-
immunostaining. BMJ Case Rep. 2017 Sep
include swollen, painful salivary glands, fe- 28;2017:bcr2017221869. doi: 10.1136/bcr- kins. She authored the current Monograph
ver, headache, fatigue, and appetite loss. 2017-221869. PMID: 28963391; PMCID: and national standard of care on Oral
PMC5652621. Lesions in HIV Seropositive Patients for
There is not currently a specific antiviral 7. Takahashi, H., Tsuboi, H., Yokosawa, M., the AIDS Institute. Dr. Brown has lectured
treatment for mumps. It is preventable by Asashima, H., Hirota, T., Kondo, Y., Matsumo- extensively on the topic of HIV/AIDS,
a vaccine, consisting of a live attenuated to, I., & Sumida, T. (2018). Diffusion-weighted Common Oral Lesions, Infection Control,
magnetic resonance imaging of parotid glands
mumps virus and is typically given in com- before and after abatacept therapy in patients with and Oral Cancer since 1992.
bination with the measles and rubella vac- Sjögren’s syndrome associated with rheumatoid
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