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Heerfordt Syndrome Bilateral CN VII — RACP Adult Medicine MCQ

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ModerateGeneral Internal MedicineHeerfordt Syndrome Bilateral CN VIIRACP Adult Medicine

A 35-year-old man presents with painless bilateral parotid swelling and bilateral uveitis. His serum ACE level is elevated and CT chest shows bilateral hilar lymphadenopathy. Biopsy of a parotid gland shows non-caseating granulomas. He develops bilateral facial nerve palsies. What syndrome does this represent?

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Correct answer: A — Sjögren syndrome

Heerfordt syndrome (uveoparotid fever) is a specific clinical presentation of sarcoidosis characterised by parotid gland enlargement, uveitis, fever, and cranial nerve palsies (facial nerve – CN VII is most commonly affected). It has a generally favourable prognosis with >90% spontaneous resolution, though corticosteroid treatment accelerates recovery of cranial nerve function and controls uveitis. Bilateral facial nerve palsies in particular should prompt consideration of sarcoidosis, Lyme disease, GBS, and HIV.

Reference: eTG – 2025 – Respiratory; eTG – 2025 – Neurology