SHM Converge Scientific Abstract ePoster Gallery-Contrast Induced Sialadenitis

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This case describes contrast-induced sialadenitis (CIS), a rare, often underrecognized pseudo-allergic reaction to iodinated contrast media that causes painless swelling of the salivary glands, most commonly the submandibular glands. A 76-year-old woman with stage 4 chronic kidney disease, inflammatory bowel disease with ileostomy, and acute congestive heart failure received iopamidol contrast for CT angiography to evaluate possible pulmonary embolism. About 13 hours later, she developed neck swelling and erythema without dysphagia, dysphonia, or abnormal vital signs. CT of the neck showed enlarged submandibular glands and surrounding edema. Infectious and thrombotic causes were excluded, and serum iodine was markedly elevated at 100,000 µg/L, supporting the diagnosis of CIS. <br /><br />She was treated with two doses of IV methylprednisolone, while IV fluids and NSAIDs were avoided because of heart failure and kidney disease. Her swelling improved the next day and fully resolved before discharge. <br /><br />The report emphasizes that CIS is thought to result from iodine accumulation in salivary glands, causing local inflammation and duct obstruction. Risk factors may include impaired iodine clearance, dehydration, and diuretic use, though CIS can also occur without predisposing factors. Onset can range from minutes to several days after contrast exposure. Management is usually supportive, with steroids reserved for prolonged or severe cases. Because the condition is self-limiting and not a true allergy, awareness of CIS can prevent unnecessary diagnostic testing, treatment, and concern about future contrast reactions, although repeat contrast exposure should still be considered carefully.

Asset Subtitle

Nkoyo Effiom

Meta Tag

Author List Albert A. Annan, Anunaya Aashish, Farah Shah, Kamran Chaudhry, Mandvi Pandey, Nkoyo Effiom

Category Clinical Vignettes

Concept Contrast-Induced Sialadenitis

Concept Iodinated Contrast

Concept Supportive Care

Concept Salivary Gland Swelling

Concept Pseudo-Allergic Reaction

Distinguished Non-Finalist

Presenter Organization Texas Health Resources HEB/Denton

Presenting Author Nkoyo Effiom

Track Adult

Keywords

contrast-induced sialadenitis

iodinated contrast media

submandibular gland swelling

pseudo-allergic reaction

iopamidol

serum iodine elevation

chronic kidney disease

methylprednisolone

salivary gland inflammation

CT angiography

Contrast-Induced Sialadenitis

Iodinated Contrast

Supportive Care

Salivary Gland Swelling

Pseudo-Allergic Reaction