Hofauer Benedikt, Wiesner Miriam, Stock Konrad, Peltz Friedhelm, Johnson Felix, Zhu Zhaojun, Chaker Adam, Knopf Andreas
Otorhinolaryngology/Head and Neck Surgery, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
Pneumology, Klinikum Rechts der Isar, Technical University of Munich, 81675 Munich, Germany.
J Clin Med. 2022 Apr 20;11(9):2292. doi: 10.3390/jcm11092292.
Sarcoidosis is a systemic inflammatory disease characterized by non-caseating granulomas. In addition to the lungs as classical site of affection, extrapulmonary manifestations are common, for example in the cervical lymph nodes or the salivary glands. The aim of this investigation is the analysis of the long-term course of glandular symptoms and the sonographic evaluation of long-term salivary gland changes.
All patients with a diagnosis of sarcoidosis over a period of 20 years in the departments of otorhinolaryngology, rheumatology, and pneumology were identified. In addition to clinical examinations and functional evaluation of the salivary glands, a sonographic examination of the salivary glands was carried out. The changes in the area of the salivary glands were assessed using B-mode sonography and different elastographic methods with appropriate scoring systems.
A total of 76 patients were included in the study (age 35.1 ± 21.6 years). Overall, 17 patients presented with salivary gland manifestation at the time of the initial diagnosis. Of these patients, 15 received steroid therapy, 6 were also treated with another drug, and 2 patients were not treated with drugs. The time span between initial diagnosis and follow-up was 88.2 months (±83.0). At the time of the initial diagnosis, 17/17 complained of swelling of the salivary glands, 9/17 of xerostomia, and 8/17 of pain in the area of the salivary glands. At the time of follow-up, 5/17 reported swelling of the salivary glands, 6/17 reported xerostomia, and 1/17 reported pain in the salivary gland area. Sonography showed sonomorphological abnormalities of the salivary glands only in individual cases, with only mild alterations on average.
In summary, it can be observed that patients with initial symptoms in the area of the salivary glands, such as swelling or pain, also suffer more frequently from dry mouth and eyes. In all patients, however, these symptoms regressed over time. A previous diagnosis of sarcoidosis with involvement of the salivary glands only leads to permanent abnormalities in the area of the salivary glands in individual cases.
结节病是一种以非干酪样肉芽肿为特征的全身性炎症性疾病。除肺部作为典型受累部位外，肺外表现也很常见，例如颈部淋巴结或唾液腺受累。本研究的目的是分析腺体症状的长期病程以及对唾液腺长期变化进行超声评估。
确定了在20年期间于耳鼻喉科、风湿病科和肺病科诊断为结节病的所有患者。除了对唾液腺进行临床检查和功能评估外，还对唾液腺进行了超声检查。使用B型超声和不同的弹性成像方法及适当的评分系统评估唾液腺面积的变化。
本研究共纳入76例患者（年龄35.1±21.6岁）。总体而言，17例患者在初次诊断时出现唾液腺表现。其中，15例接受了类固醇治疗，6例还接受了另一种药物治疗，2例患者未接受药物治疗。初次诊断与随访之间的时间跨度为88.2个月（±83.0）。初次诊断时，17/17例患者主诉唾液腺肿胀，9/17例患者有口干，8/17例患者唾液腺区域疼痛。随访时，5/17例患者报告唾液腺肿胀，6/17例患者报告口干，1/17例患者报告唾液腺区域疼痛。超声检查仅在个别病例中显示唾液腺的超声形态学异常，平均仅有轻度改变。
总之，可以观察到唾液腺区域有初始症状（如肿胀或疼痛）的患者也更频繁地出现口干和眼干症状。然而，在所有患者中，这些症状随时间推移而消退。既往诊断为结节病且唾液腺受累仅在个别病例中导致唾液腺区域出现永久性异常。
