Pediatric Macroglossia (Large Tongue)

Pediatric Macroglossia (Large Tongue)



Macroglossia describes an unusually large tongue, which can be caused by several conditions.

Expanded overview

Children can either be born with (congenital) an enlarged tongue or develop it after birth (acquired) in response to a medical condition. This uncommon disorder can cause difficulties breathing, eating, sleeping, speaking and swallowing.


Some children are born with an abnormally large tongue due to genetics. Other children can have a large tongue due to several medical conditions:

  • Acromegaly (gigantism) – pituitary gland produces too much growth hormone
  • Amyloidosis – a rare disease in which amyloid proteins (made in the bone marrow) are deposited on tissues and organs
  • Beckwith-Wiedemann syndrome – a genetic overgrowth disorder that affects organs/tissues
  • Cancer – tumors on the tongue or in specific glands can cause the tongue to swell
  • Down syndrome – a genetic disorder causing developmental and intellectual delays
  • Hemangioma – a benign tumor of tiny blood vessels
  • Hypothyroidism – the thyroid gland doesn’t produce enough of the hormone that typically impacts development and growth
  • Oral herpes simplex virus  – an infection marked sores around the mouth or on the tongue
  • Kawasaki disease – inflammation in the walls of some blood vessels in the body
  • Sarcoidosis – tiny collections of painful, inflammatory cells in various locations of the body
  • Structural abnormalities – irregularities that affect the blood vessels or muscle masses
  • Thrush – a fungal infection in the mouth that causes the tongue to turn white


Symptoms will vary according to the cause and severity of the condition responsible for macroglossia. Symptoms can include:

  • Airway obstruction
  • Difficulty eating
  • Drooling
  • Irregular growth of the jaw and teeth
  • Open sore
  • Sleep apnea (temporarily stop breathing while sleeping) or snoring
  • Speech impairment
  • Stridor (high-pitched whistle made when trying to breathe)
  • Tissue death on the tip of the tongue

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