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Recurrent Swellings of the Parotid Gland, Sialectasis and Mikulicz's Syndrome

1979; SAGE Publishing; Volume: 72; Issue: 8 Linguagem: Inglês

10.1177/014107687907200809

1758-1095

John Maynard,

Autoimmune Bullous Skin Diseases

Recurrent parotitis has been a confused subject for many years.In 1892, Mikulicz described a case of lacrimal gland, submandibular gland and parotid gland swelling in a 42-year-old Prussian farmer.Biopsy of the parotid showed a 'uniformly arranged tissue consisting of small round cells'.In 1925 Gougerot (a French dermatologist) described patients with progressive atrophy of the salivary glands, lacrimal, nasal, laryngeal and vulval glands.In 1933, Sjogren described similar cases and was particularly interested in keratoconjunctivitis sicca.In 1953 Morgan & Castleman for the first time linked Mikulicz's syndrome and Sjogren's disease as probably the same disease process.Godwin (1952) described 10 cases with benign lymphoepithelial lesions which were histologically identical with the findings in Sjogren's and Mikulicz's disease.This collection of diseases has now been recognized to have an autoimmune basis.Antibiotics to salivary-duct epithelium have been demonstrated and serum protein studies have shown characteristic abnormalities associated with autoimmune disease.Amidst this collection of diseases there appears to be a group of patients with recurrent swelling of the parotid glands, who have no associated keratoconjunctivitis sicca or associated arthritis and no abnormality of their serum protein suggestive of an autoimmune process.Although this group is recognized it has been thought by some authors to represent an incomplete form of Sjogren's disease (Shearn 1971).Nearly 300 of such patients have been collected, treated and followed up over the last fifteen years.The initial investigation started in 1963 (Maynard 1965) and consisted of a study of the natural history, an investigation of the aetiology and an attempt to find an alternative to parotidectomy as treatment for patients with severe symptoms.