Eosinophilic sialodochitis: An emerging atopic condition

Oral Dis. 2022 Apr;28(3):648-656. doi: 10.1111/odi.13821. Epub 2021 Mar 12.

Abstract

Objective: To report the clinical characteristics of the largest single centre cohort of patients with eosinophilic sialodochitis.

Methods: Analysis of data relating to 37 patients seen in a dedicated multidisciplinary clinic was performed. Demographic, clinical, haematological, cytological, histological and radiological features were collated. Response to trials of allergy treatment was assessed.

Results: Thirty-seven patients (30 female, seven male) were identified, 42% of whom were of Afro-Caribbean origin, with a mean age of 50.4 years (range 28-80 years). Mean symptom duration at presentation was 10 years (range 2-33 years). Parotid and submandibular gland involvement was equally reported. The most commonly reported symptoms were swelling (97%), itching of the overlying skin (92%), salivary gland discomfort (84%) and "string-like" mucus discharge from salivary duct orifices (76%). Twenty-three patients (62%) demonstrated atopic disease and serum IgE level elevated in 57%. All 37 patients had eosinophils present in aspirated duct contents samples while raised peripheral eosinophil count was seen in 41%. Anecdotal symptom improvement was reported with antihistamine, antileukotriene or steroid treatment.

Conclusion: Eosinophilic sialodochitis should be considered in any patient presenting with recurrent salivary gland swelling. Further studies are needed to evaluate treatments directed at a likely allergic pathogenesis.

Keywords: allergic parotitis; eosinophilia; eosinophilic sialodochitis; salivary glands; sialodochitis fibrinosa.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Eosinophils
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parotid Gland / pathology
  • Salivary Ducts
  • Sialadenitis* / pathology
  • Submandibular Gland