Heerfordt's Syndrome Associated with Trigeminal Nerve Palsy and Reversed Halo Sign

• Published in: Internal Medicine Vol. 60; no. 11; pp. 1747 - 1752
• Main Authors: Makimoto, Go, Kawakado, Keita, Nakanishi, Masamoto, Tamura, Tomoki, Noda, Minori, Makimoto, Satoko, Sato, Yumiko, Kuyama, Shoichi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.06.2021; Japan Science and Technology Agency
• Subjects: Biopsy; Case Report; Case reports; Corticosteroids; Cranial nerves; endobronchial ultrasound-guided transbronchial needle aspiration; Fever; Heerfordt's syndrome; Internal medicine; Lymph nodes; Neurological disorders; Paralysis; Parotid gland; reversed halo sign; Sarcoidosis; Trigeminal nerve; trigeminal nerve palsy; Ultrasound; Uveitis; endobronchial ultrasound-guided transbronchial needle aspiration; Heerfordt's syndrome; reversed halo sign; trigeminal nerve palsy
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.6176-20

Heerfordt's syndrome is a rare subtype of sarcoidosis and features a combination of facial palsy, parotid swelling, and uveitis, associated with a low-grade fever. Cases with two of three symptoms are called "incomplete Heerfordt's syndrome." Heerfordt's syndrome involving other cranial nerve symptoms is relatively rare. We herein report a case of incomplete Heerfordt's syndrome presenting with trigeminal nerve palsy and a reversed halo sign, a rare manifestation of pulmonary sarcoidosis. The histological diagnosis following a biopsy of the parotid gland and endobronchial ultrasound-guided trans-bronchial needle aspiration of the mediastinal lymph nodes was sarcoidosis. The symptoms and lung lesions improved after corticosteroid therapy.