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[Clinical diagnosis of salivary gland sarcoidosis (Heerfordt syndrome)].

HNO 2000 August
Sarcoidosis, a systemic granulomatous disease of unknown cause, may involve any body organ. The most common manifestation in the head-neck area is lymph node sarcoidosis or, alternatively, Heerfordt's syndrome (with involvement of lacrimal and parotid gland and possible facial palsy). Far less common is a isolated laryngeal sarcoidosis. The typical histopathological appearance proves the diagnosis. However, obtaining representative and sufficient biopsy material in some cases may carry risks for the patients or might technically be difficult. In these cases, the clinician can fall back on two other, noninvasive diagnostic procedures: ACE level activity determination in blood serum and 67gallium citrate scintigraphy. Elevated ACE levels in combination with a positive 67gallium scintigraphy have a specificity (combined) of 99%. As a valuable side effect, this procedure sensitively may discover additional disease in the body and also serves well as a therapy-control examination. The presented case report shows clearly that these clinical methods, if combined, are sufficient for diagnosis of Heerfordt's syndrome/sarcoidosis; no additional histopathological examination is required.

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