Sialoendoscopy in Juvenile Recurrent Parotitis That Could be Primary Pediatric Sjogren’s Syndrome

Brigida Iorio, R. Luca, G. Tartaro, G. Colella
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Abstract

Parotid swelling often is encountered in the pediatric population, essentially acute and self-limiting, which usually represents viral or bacterial infections. Less common etiologies include juvenile recurrent parotitis (JRP) or pneumoparotid or anatomic abnormalities. Sjögren’s syndrome is common in JRP (40% almost). Levels of suspicion for an autoimmune disorder should be maintained for children affected by JRP, particulary in bilateral glands involvement in order to optimize diagnoses and facilitate treatment. Cytological examination of saliva, which is normally in children is acellular, shows granulocytes, lymphocytes, and in some cases 50% of bacteria. Sialoendoscopy typically shows whitish ductal walls and the presence of stenosis without evidence of solid obstructions and/or mucous membranes. Sialoendoscopic treatment can improve symptoms thanks to local anti-inflammatory therapy and sialoendoscopic washing.
可能是原发性小儿干燥综合征的青少年复发性腮腺炎的涎腺内镜检查
腮腺肿胀经常发生在儿科人群中,基本上是急性和自限性的,通常代表病毒或细菌感染。较不常见的病因包括青少年复发性腮腺炎(JRP)或腮腺气肿或解剖异常。Sjögren综合征在JRP中很常见(约占40%)。对于受JRP影响的儿童,特别是双侧腺体受累的儿童,应保持对自身免疫性疾病的怀疑水平,以优化诊断和促进治疗。唾液细胞学检查,通常在儿童是无细胞的,显示粒细胞,淋巴细胞,在某些情况下,50%的细菌。涎腺内窥镜检查通常显示白色的导管壁和狭窄的存在,没有固体阻塞和/或粘膜的证据。通过局部抗炎治疗和鼻内镜冲洗,鼻内镜治疗可改善症状。
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