Studies on newly recognized chronic sialadenitis.
- Author:
Guang Yan YU
1
;
Deng Gao LIU
2
;
Wei LI
1
;
Xia HONG
1
;
Yan Yan ZHANG
1
;
Wen Xuan ZHU
1
;
Ke Fu ZHANG
1
;
Xiao LI
1
;
Zhan Guo LI
3
;
Yan Ying LIU
4
;
Yan CHEN
5
;
Yan GAO
5
;
Jia Zeng SU
1
Author Information
1. Department of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key laboratory of Digital Stomatology, Beijing 100081, China.
2. Department of Oral Radiology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key laboratory of Digital Stomatology, Beijing 100081, China.
3. Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, 100044, China.
4. Department of Rheumatology and Immunology, Capital Medical University Affiliated Beijing Friendship Hospital, 100050, China.
5. Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key laboratory of Digital Stomatology, Beijing 100081, China.
- Publication Type:Journal Article
- Keywords:
Eosinophilic sialodochitis;
IgG4-related sialadenitis;
Parotid gland;
Radioactive iodine-induced sialadenitis;
Salivary gland;
Submandibular gland
- MeSH:
Humans;
Immunoglobulin G;
Iodine Radioisotopes;
Salivary Glands;
Sialadenitis/etiology*;
Submandibular Gland
- From:
Journal of Peking University(Health Sciences)
2022;54(1):13-17
- CountryChina
- Language:Chinese
-
Abstract:
Some kinds of chronic sialadenitis were recognized during the recent years. They have specific pathogenesis, clinical and histopathologic appearances, and require specific treatment. IgG4-related sialadenitis (IgG4-RS) is one of the immune-mediated diseases, characterized by tumefactive lesions. The incidence of IgG4-RS obviously increased during the past 30 years. The study on the potential relationship between occupational exposure to chemical substances and the incidence of IgG4-RS showed that subjects with occupational exposure to agents known to cause IgG4-RD had an increased risk for IgG4-RS. Surgical excision of involved SMG could not control the disease progression, which is not recommended for treatment of IgG4-RS. The combination of glucocorticoid and steroid-sparing agents is effective for treating IgG4-RS, and restores salivary gland function. Radioiodine induced sialadenitis (RAIS) is one of the common complications of postoperative adjuvant treatment of differentiated thyroid cancer by 131I. The incidence of the disease is related to radiation dosage. Clinically, the patients suffered from swelling and tenderness in the buccal or submandibular regions, especially during the mealtime. Imaging appearances are similar to those of chronic obstructive sialadenitis. Conservative managements, such as gland massage, sialagogues, are the mainstream methods in the treatment of RAIS. Sialendoscopy is feasible for RAIS, but not as effective as conventional obstructive sialadenitis (COS). Therefore the prevention of RAIS is crucial. Eosinophilic sialodochitis (ES) is a new type of chronic inflammatory disease of the salivary gland related to allergy. It has characteristics of swelling of multiple major salivary glands, strip-like gelatinous plugs discharged from the duct orifice of the gland, elevated level of serum IgE and eosinophils in peripheral blood, infiltration of eosinophils and IgE positive plasma cells in the tissues, allergic history, increased expression of allergy-related cytokines, such as IL-4, IL-5, IL-13, and eotaxin, which suggest allergic reactions as a potential pathogenesis of the disease. The clinical, laboratory, histological, and immunohistochemical characteristics of ES are significantly different from conventional obstructive sialadenitis (COS). Therefore, it is suitable to separate ES from COS. Conservative managements, such as self-maintenance therapy and anti- allergic modality are the choices of treatment for ES. Based on the results of our comprehensive studies a new classification of chronic sialadenitis is suggested.
