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bilateral parotid gland swelling
Jun 15, 2008

I am HIV+ for 27 years. Current med regimen is Sustiva/Viread/Epivir/Oxandrin with 200 +/- CD4 for the last 3 years and an undetectable viral load. Ive been receiving Sculptra treatments for the last 3 years.

Ive had bilateral cheek swelling for the last 18+ months. By sight alone the plastic surgeon said it was a build up of lymphoepithelial cells in my parotid glands. He told me other patients of his used low level radiation to resolve the problem. My primary physician referred me for a complete workup (with biopsies) and I received the same diagnosis. The PA who assisted during the workup said that doxycycline injections into the cheeks might be of benefit but this was never mentioned by the specialist who did the workup. My primary physician is not comfortable with radiation (nor am I) and hasnt suggested the doxycycline approach.

As of late I have noticed that my jaw has become somewhat less flexible (i.e, eating requires me to cut food down to smaller size bites, a dental visit was difficult because I couldnt open my mouth easily for x-rays, cleaning, etc.). Saliva flow remains normal per physician and dentist observations.

Any suggestions on how to address this problem? Could this be related to Sculptra therapy?

Thanks! Glenn

Response from Dr. Pierone

Hello and thanks for posting.

Parotid swelling occasionally does complicate HIV infection and is almost always a benign process. When it develops off treatment, starting antiretroviral therapy often leads to improvement of the parotid swelling. I have not heard of or seen Sculptra causing parotid swelling.

Doxycycline sclerotherapy may be useful for treatment of parotid cysts, but cannot imagine how it would be used for generalized parotid swelling. In your situation I suspect the best approach would probably be low dose radiation therapy. Good luck!



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