Sialadenosis
Classification according to ICD-10 | |
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K11.8 | Other diseases of the salivary gland |
ICD-10 online (WHO version 2019) |
When Sialadenosis is in contrast to Sialadenitis a non-inflammatory disease of the parenchyma of the salivary glands . Originally, the Sialadenosis was as Sialose referred
causes
It is a secretion disorder of the salivary gland tissue due to malfunction of the autonomic nervous system .
Common causes
- Sialadenosis can be associated with endocrine disorders (e.g. pituitary and thyroid disorders ) or
- hormonal dysfunction such as diabetes mellitus , pregnancy, puberty , or menopause
- occur as a result of malnutrition, for example with chronic protein or vitamin deficiency , in the context of a psychogenic eating disorder (e.g. anorexia nervosa with vomiting or bulimia ), starvation dystrophy or in the presence of alcoholism with cirrhosis of the liver or fatty liver.
- Another cause may be the side effect of antihypertensive drugs (e.g. as in the. Noradrenaline - derivative isoproterenol ).
Rare causes
Furthermore, sialadenoses
- caused by diseases or injuries to the facial nerve (e.g. iatrogenic injuries to the chorda tympani ) or the glossopharyngeal nerve .
- There are case reports of a possible association of sialadenosis with ADH- treated diabetes insipidus .
Histological changes
The histological picture is characterized by myoepithelial and acinar cell changes. The acinar cells (gland cells) are twice to three times larger than normal. There is no infiltration by inflammatory cells.
Symptoms
The mostly bilateral salivary gland swellings in sialadenoses mainly affect the parotid glands . Occasionally, patients feel tension pain, especially when the glands are severely swollen, but in contrast to bacterial inflammation of the salivary glands, the disease is usually hardly painful. Characteristically, the swelling is independent of food consumption. Younger women get sick more often than men, especially after puberty and pregnancy.
Differential diagnosis
A number of other parotid gland diseases are associated with enlarged glands . The harmless masseter hypertrophy can also simulate an enlarged salivary gland.
- Bacterial inflammation of the salivary glands ( sialadenitis ) - it is associated with fever, feeling sick and severe pain.
- Salivary gland stones ( sialolithiasis ) - this is where the swelling increases when you eat.
- Parotitis epidemica ( mumps ) - additionally fever and often cold symptoms, mostly in children.
- Salivary gland tumors - in contrast to sialadenosis, the swelling is nodular, hard and usually one-sided.
- Hypertrophy of the masticatory muscles ( masseter hypertrophy ).
therapy
A specific therapy for sialadenoses is not known. If endocrine disorders exist (diabetes, thyroid dysfunction), these underlying diseases must be adequately treated. Vitamin and protein deficiencies in the case of nutritional disorders are compensated for. If you suspect drug side effects from antihypertensive drugs such as clonidine or furosemide , a change in preparation can improve the symptoms. In very severe cases, the parotid gland can be surgically removed.
Individual evidence
- ↑ zm-online.de ( Memento of the original from October 29, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice.
- ^ S. Rauch: Physiology and pathology of the salivary glands. In: Switzerland Med Wochenschr. 1956 Jul 7; 86 (27), pp. 771-775. PMID 13351596 .
- ↑ AWMF guideline diagnosis and therapy of eating disorders. Long version, p. 50.
- ^ G. Seifert, K. Donath: Classification of the pathohistology of diseases of the salivary glands - review of 2,600 cases in the Salivary Gland Register. In: Contribution Pathol. 1976 Oct; 159 (1), pp. 1-32. PMID 999595
- ↑ M. Borkeloh, A. Teymoortash, JA Werner, R. Mandic: Sialadenoses of the head salivary glands - a consequence of disorders of the body's water balance? In: ENT information (congress abstracts). 84, 2005, doi: 10.1055 / s-2005-869373 .
Web links
- Histological image of a sialadenosis in Papanicolaou staining on PathoPic