Heerfordt syndrome  is a rare manifestation of sarcoidosis. The symptoms include inflammation of the eye (uveitis), swelling of the parotid gland, chronic fever, and in some cases, palsy of the facial nerves. Causes
The exact cause of Heerfordt syndrome has not yet been definitively determined. Of those patients who have been diagnosed with Heerfordt syndrome, 15% have a close relative who also has the syndrome. One possible explanation is that the syndrome results from a combination of an environmental agent and a hereditary predisposition. Mycobacterium and Propionibacteria species have both been suggested as the environmental agent, though the evidence for this is inconclusive. Diagnosis
In patients that have already been diagnosed with sarcoidosis, Heerfordt syndrome can be inferred from the major symptoms of the syndrome, which include parotitis, fever, facial nerve palsy and anterior uveitis. In cases of parotitis, ultrasound-guided biopsy is used to exclude the possibility of lymphoma. There are many possible causes of facial nerve palsy, including Lyme disease, HIV, Melkersson–Rosenthal syndrome, schwannoma, and Bells palsy. Heerfordt syndrome exhibits spontaneous remission. Treatment
Treatments for sarcoidosis include corticosteroids and immunosuppressive drugs. Prevalence
In the United States, sarcoidosis has a prevalence of approximately 10 cases per 100,000 whites and 36 cases per 100,000 blacks. Heerfordt syndrome is present in 4.1 to 5.6% of those with sarcoidosis. History
The condition was first described in 1909 by Danish ophthalmologist Christian Frederick Heerfordt, for whom the syndrome is now named.
Cevimeline (trade name Evoxac) is a synthetic analog of the natural alkaloid muscarine with a particular agonistic effect on M1 and M3 receptors. It is used in the treatment of dry mouth and Sjögrens syndrome. Medical uses
Cevimeline is used in the treatment of xerostomia (dry mouth), and Sjögrens syndrome. It increases the production of saliva. Side effects
Known side effects include nausea, vomiting, diarrhea, excessive sweating, rash, headache, runny nose, cough, drowsiness, hot flashes, blurred vision, and difficulty sleeping.Contraindications include asthma and angle closure glaucoma. Mechanism of action
Cevimeline is a cholinergic agonist. It has a particular effect on M1 and M3 receptors. By activating the M3 receptors of the parasympathetic nervous system, cevimeline stimulates secretion by the salivary glands, thereby alleviating dry mouth. See also
Pilocarpine — a similar parasympathomimetic medication for dry mouth (xerostomia)
Bethanechol — a similar muscarinic parasympathomimetic with longer-lasting effect

References
External links
Evoxac (cevimeline HCl hydrate capsules) Full Prescribing Information