AN OTHERWISE healthy 26-year-old white woman presented with bilateral parotid gland swelling in January 2000. She reported that she had had a severe bout of mononucleosis in November 1999, with fevers, chills, odynophagia, fatigue, severe myalgias and arthralgias, and enlarged parotid glands. Further history revealed occasional dry eyes, dry skin, and a "clicking" with swallowing. She denied shortness of breath, cough, dysphagia, odynophagia, skin lesions, and recent weight loss. Except for persistent parotid swelling, her symptoms had resolved. Before presenting at our clinic, she had received 4 short courses of corticosteroids that had significantly reduced the swelling.