Submaxillary gland enlargement caused by reduced glutathione
Department of Gastroenterology, Fuyang Hospital of Anhui Medical University, Anhui Province, Fuyang 236000, China; Department of Pharmacy, Fuyang Hospital of Anhui Medical University, Anhui Province, Fuyang 236000, China
Abstract:A 44-year-old male patient was hospitalized twice for chronic hepatitis B and alcoholic cirrhosis with hepatic encephalopathy. During the 2 times of hospitalization, the patient was treated with reduced glutathione and ornithine aspartate and developed bilateral submandibular gland enlargement on the 2nd day after the first medication in each hospitalization. Physical examination showed no abnormal skin color and temperature, no obvious tenderness, intact oral mucosa, and no redness and swelling of submandibular gland duct orifice. Ultrasonic examination showed diffuse enlargement of bilateral submandibular gland and visible peripheral lymph nodes and bilateral cervical lymph nodes. It was never aware to be drug-related in the first occurrence of submandibular gland enlargement, therefore the drug was not stopped and no special treatment was given. The patient′s submandibular gland enlargement subsided spontaneously 2 days later. During the 2nd hospitalization, the patient developed bilateral submandibular gland enlargement again, which was considered to be related to reduced glutathione because no submandibular gland enlargement appeared in the patient during the repeated use of ornithine aspartate in the past. Then the reduced glutathione was stopped and ornithine aspartate was continued. The patient′s submandibular gland enlargement subsided completely 1 day later.