Bilateral parotid gland involvement in Wegener granulomatosis

Wegener granulomatosis (WG) is a disease characterised by granulomatous inflammation and a vasculitis predominantly affecting small vessels.1 We describe a patient with WG who presented with bilateral parotid gland involvement, which is particularly unusual. An 18-year-old woman with asthma presented with symptoms consistent with sinusitis with bilateral parotid gland swelling. She was treated with antibiotics over a 4-week period. Her symptoms failed to improve and she developed an enlarged lacrimal gland 2 months later, associated with 10 kg weight loss and lower limb arthralgia. Her C-reactive protein was 187 mg/l (normal <5 mg/l) and her erythrocyte sedimentation rate was 56 mm/h (normal 1–10 mm/h). A biopsy of the left parotid gland showed …