Acute Swelling of the Neck after Contrast Media Containing Iodine - Iodide Mumps Mistaken as Allergic Angioedema - Three Cases

Three female patients are presented who were referred for evaluation of acute neck swellings after examination with iodinated contrast media. Acute angioedema was suspected in all three but did not respond adequately to antihistamines and corticosteroids. The patients were eventually diagnosed with so-called iodine mumps or iodine-associated sialoadenopathy. Sonographically and histologically, there was only edema of the salivary glands, but no evidence of a pronounced inflammatory reaction. This complication is not uncommon and is triggered by iodine itself, as could be demonstrated by provocation with iodine potassium iodide (Lugol solution). The pathophysiologically unexplained iodine-associated sialoadenopathy is thus classified as an idiosyncratic reaction.