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PubMed1992

Sialochemistry in human immunodeficiency virus associated salivary gland disease.

Human immunodeficiency virus (HIV) associated salivary gland disease is defined as the presence of enlargement of one or more major salivary glands and/or diminished salivary function in an HIV infected individual. It has a number of similarities to, as well as differences from, Sjögren's syndrome (SS). We studied the sialochemistry of stimulated parotid saliva of 11 patients with HIV associated salivary gland disease and bilateral parotid gland enlargement, and compared these findings with those of 15 HIV negative controls, 13 HIV positive individuals with no salivary gland involvement and 18 individuals with SS. The patients with HIV associated salivary gland disease had a significant decrease in the level of salivary protein, with increases in salivary IgA, lysozyme and albumin compared to the HIV negative controls. There were no changes in concentration of electrolytes. The sialochemistry among the patients with HIV associated salivary gland disease was unrelated to the degree of immune suppression and did not change over a 6 month period. The observed changes were similar to those of SS but less pronounced. The similar clinical, histologic and sialochemical features of HIV associated salivary gland disease and SS suggest that these conditions share common pathogenetic mechanisms, which may be modified in the former by the HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Sialographic and sonographic diagnosis of salivary gland diseases].

The diagnostic value of sialography and ultrasonography was studied retrospectively in 130 patients with diseases of the salivary gland. In the diagnosis of tumours (sensitivity: 97.5% vs 52.5%), acute inflammatory diseases (sensitivity: 70% vs 40%) and abscesses (sensitivity: 100% vs 25%) ultrasound was more accurate than sialography. Even in the diagnosis of calculi, ultrasound gave good results (sensitivity: 71.4%) and should be performed before the more invasive sialography technique. In chronic inflammatory diseases, sialography continues to be the technique of choice.

Abscess↗
PubMed1989

Does HIV cause salivary gland disease?

HIV-associated salivary gland disease (HIV-SGD) is characterized by enlargement of the major salivary glands and/or xerostomia. HIV does not appear to play a direct role in this disease since it was detected by immunohistochemistry in only occasional lymphocytes in labial salivary glands in two out of six patients; it was not found in the salivary gland epithelial cells. Moreover, HIV was not found in any of 21 saliva samples from seven patients. We conclude that HIV-SGD is not caused by direct infection of the salivary glands with HIV.

Adult↗
PubMed1984

Medical management of non-neoplastic salivary gland disease.

Non-neoplastic salivary gland disorders are increasing as a result of many factors. The role of salivary secretion in providing protection to the oral and pharyngeal tissues is discussed along with the diagnosis and treatment of some of the more common non-neoplastic salivary gland diseases.

Adrenal Cortex Hormones↗
PubMed2001

[Imaging in major salivary gland diseases]

Most of the salivary glands diseases are characterized only by a few distinct clinical patterns. Medical history and clinical examination are still considered of great relevance. However, in order to obtain a definite diagnosis, imaging techniques are required in most of the cases. Salivary glands ultrasonography (US) is the technique to be used as the first because US can easily differentiate calculosis, inflammatory diseases and tumors. Sonography is also frequently needed to perform needle aspiration or biopsy (FNAC). Sialography should be used essentially for assessing chronic sialoadenitis as well as Sjögren's syndrome. At present, Magnetic Resonance sialography should be preferred because of the greater sensibility in diagnosing inflammatory diseases of the salivary glands. It allows to evaluate both intraglandular oedema and nodules, so that incannulation of the salivary duct is not required. Computer Tomography (CT) and Magnetic Resonance imaging (MR) are useful when neoplasm are suspected, particularly if deep areas of the gland, which cannot be visualized by US, are involved. Sequential scintigraphy is currently employed for assessing the functional status of all the 4 major salivary glands and evaluating the chronic evolution of glandular damage.

Journal Article↗
PubMed1985

[High-resolution real-time sonography in salivary gland diseases. I: Inflammatory diseases].

130 patients with suspected inflammation or tumors of the major salivary glands were examined by high resolution real-time sonography (7 MHz). Characteristic changes of the glandular echomorphology were found in 42 out of 46 cases with acute sialadenitis (91%). These were swelling of the gland, nonhomogenicity of the parenchymal texture and decrease of the glandular echogenicity. Intra- or extraglandular dilatation of the major duct or ductal segments were further findings in obstructive sialadenitis, particularly when associated with sialolithiasis. Ultrasound disclosed salivary stones in 5 of 5 parotid calculi and in 9 of 14 submandibular calculi with no false positive result. High resolution real-time sonography of the salivary glands has proven to be of great diagnostic value in supplementing the clinical findings.

Actinomycosis↗
PubMed1992

Natural history of HIV-associated salivary gland disease.

To describe the natural history of HIV-associated salivary gland disease, which is characterized by enlarged major salivary glands and/or xerostomia in HIV-infected persons, we assessed 22 patients at an initial and follow-up examinations (median span of examinations, 15 months). Sixteen patients (73%) had bilateral parotid gland enlargement, 17 had symptoms of dry mouth, and 11 had both conditions. Parotid gland enlargement remained unchanged in 10 patients, it progressed in 2, and it regressed in 4 during treatment with zidovudine or steroids. Those patients with parotid gland enlargement had a significantly lower mean stimulated parotid flow rate (0.27 ml/min/per gland) than a control group of HIV+ persons without salivary gland disease (0.48 ml/min/per gland) (p less than 0.05), whereas the mean unstimulated whole salivary flow rates did not did not differ significantly between the two groups. The mean salivary flow rate of the study group did not change during the observation period. When HIV-associated salivary gland disease was diagnosed, 5 patients (23%) had AIDS, and at follow-up 10 (46%) had AIDS. Seven of these had Kaposi's sarcoma. The mean peripheral blood CD4 cell count was 280 and 225 per mm3 at the initial and follow-up examinations, respectively. The corresponding CD8 counts were 1138 and 900. The pathogenesis of HIV-associated salivary gland disease may include hyperplasia of intra-parotid lymphoid tissue. Because HIV-associated salivary gland disease can clinically resemble Sjögren's syndrome, the differential diagnosis of bilateral parotid enlargement should include HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Salivary gland disease in pediatric HIV patients: an update.

Oral manifestations are one of the earliest clinical indicators of HIV infection and progression in children. Prompt recognition of these signs and symptoms by dental providers can help in the diagnosis and intervention of delaying the progression of HIV disease to AIDS. Salivary gland disease is a common manifestation of HIV infection in pediatric patients, presenting either as gland enlargement and/or xerostomia. The parotid glands by far are most frequently affected, though the other major glands are commonly involved. Diseases of the salivary glands and the corresponding quantitative changes in saliva affect the homeostasis of the oral cavity and account for significant morbidity during the progression of HIV disease. This paper summarizes the research on HIV-related salivary gland disease and outlines treatment and management considerations.

Anti-Bacterial Agents↗
PubMed1986

Salivary gland disease in children: a review. Part 1: Acquired non-neoplastic disease.

The early recognition of salivary gland disease depends upon a high index of suspicion by the clinician. A systematic approach to salivary gland disease in children is presented by a group of algorithms, which is supplemented by a discussion of the historical, physical, and diagnostic test findings characteristic of salivary gland pathology. Therapeutic alternatives are discussed for both neoplastic and non-neoplastic disorders.

Abscess↗
PubMed1987

Immunologic approaches to the therapy of auto-immune salivary gland disease.

A variety of immunologic mechanisms may theoretically give rise to disease in the salivary glands. Among them are abnormal antibody production, hyper-reactive T-lymphocytes, and mono- or oligoclonal expansions of B-lymphocytes. While it is not clear which, if any, of these mechanisms are of prime importance in the immunopathology of salivary gland disease, they provide a framework within which to discuss theoretical approaches to the treatment of auto-immune salivary gland disease. Among the techniques used to decrease antibody-induced damage are non-steroidal anti-inflammatory agents, plasmapheresis, and corticosteroids. Cyclosporin, monoclonal antibodies, and biologic response-modifiers may be used to modulate T-cell function, and anti-idiotype antibodies or immunosuppressive agents may be used to treat malignant expansions of B-cells. Although the generally benign nature of auto-immune salivary gland disease precludes the use of many of the potentially toxic treatment regimens discussed here, the appreciation of these approaches to immunomodulation provides a basis upon which to develop new and innovative therapeutic strategies.

Adrenal Cortex Hormones↗
PubMed1984

[Current status of serial sialography and sialoscintigraphy in the diagnosis of salivary gland diseases].

Sialographic investigation of enlarged salivary glands contribute to the important decision whether a secretion blockage is caused by a stone, chronic inflammation, sialoadenosis, or a tumour. The results of sialographic investigations have been much improved by the method described by Brands and Schnepper (1967) of specific serial sialography using a single-shot and fast-repeating camera, under fluoroscopic control. The success rate of the sialographic diagnosis on 141 patients in the ENT Department of Saarland University Hospital was 80%. The fact that in four cases spaces, occupying lesions were falsely interpreted or undetected leads to the conclusion that where a tumour is suspected negative sialography should be followed by further diagnostic steps. Scintigraphy of the salivary glands with 4 mCi 99mTechnetium Pertechnetate produces extra information which clearly increases diagnostic accuracy. However, experience to date shows that it is not an alternative to serial sialography but rather a supporting diagnostic method.

Adult↗
PubMed1989

Digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography in the diagnosis of salivary gland diseases.

Forty-one patients with salivary gland disorders have been evaluated by digital subtraction sialography, conventional sialography, high-resolution ultrasonography and computed tomography, and the results compared with clinical, surgical and pathomorphological data. In the case of salivary gland masses, the sensitivity of ultrasonography, CT and digital subtraction sialography was 100%, 82% and 71%, respectively, while in the case of sialadenitis, the respective figures were 54%, 69% and 85%. The image quality of digital subtraction sialography was superior to that of conventional sialography in 80%, equal in 16%, and inferior in 3% of the examinations. We conclude that in all cases of salivary gland diseases ultrasound should be the first imaging procedure. If a tumour is not confirmed, digital subtraction sialography should be employed to visualise inflammatory changes, while in most cases of salivary gland masses no further imaging will be necessary.

Humans↗