Salivary gland involvement in systemic diseases.

The salivary glands participate in systemic illnesses because they are secretory structures allied with the gastrointestinal tract. Thus they are involved in systemic inflammatory, allergic, and neoplastic conditions. Perhaps the most common condition is that of mumps in the acute phase. Of the chronic diseases, Mikulicz's disease or Sjögren's syndrome is most frequently noted. In most instances of systemic involvement, the salivary gland enlargement is the rule, with the gland being tense, soft, and enlarged, and with progressive growth over a period of time. Usually all glands are involved. The diagnosis should be suspected from the history and the physical examination, noting that all the glands are equally involved by the enlargement. If there is any question, a biopsy should be performed. In the case of Sjögren's syndrome, the biopsy specimen may be taken either from a major salivary gland or from one of the minor ones, or the nasal mucous membrane or oral cavity. In general, definitive therapy is unsuccessful for the systemic illness involving the salivary glands, and in most instances has to be supportive.