Parotid gland swelling in primary Sjögren’s syndrome: activity and other sialadenosis causes

Abstract

Objective To assess the prevalence of parotid gland swelling (PGS) and its association with features of SS and other causes of sialadenosis in a Latin-American cohort of primary SS. Methods We included 668 patients from Argentina, Brazil, Mexico and Paraguay. We retrospectively registered demographics, disease duration, oral/ocular symptoms, serology and scored the basal ESSDAI. We defined PGS as a recurrent or persistent increase of volume of any parotid glands during adulthood (self-reported and/or physical examination). We registered the presence of diabetes mellitus, dyslipidaemia, body mass index and alcohol consumption. We used logistic regression analysis reporting odds ratio (OR) and 95% CI. Results PGS was present in 242 patients (36.2%): 78 previous to SS diagnosis, 86 concomitantly, 73 during follow-up and five unknown. At the multivariate analysis, PGS was associated with RF (OR 2.47, 95% CI: 1.1, 6.5, P = 0.0001), basal articular ESSDAI domain (OR 1.63, 95% CI: 1.01, 2.6, P = 0.04) and alcohol consumption (OR 2.42, 95% CI: 1.41, 4-15). Patients with PGS during the follow-up had a higher prevalence of alcohol consumption (45.3%) compared with the remaining PGS cases (26.8%; OR 2.41 95% CI: 1.2, 4.7), or patients without parotid gland swelling (15.6%; OR 3.8 95% CI: 1.7, 8.2) in all the adjusted models. Conclusion PGS generally precedes or presents concomitantly with SS diagnosis, and is related to RF and articular activity. Alcohol consumption is an additional factor in PGS, especially during follow-up. The meaning of this last finding as well as its prognostic implications remains to be elucidated and deserves further evaluation in prospective studies.

Facilitating Nitrite-Derived S-Nitrosothiol Formation in the Upper Gastrointestinal Tract in the Therapy of Cardiovascular Diseases

“…The ablation or reduced function of this gland may be observed in patients undergoing treatment for oral or head and neck cancers, particularly those treated with radiotherapy [ 138 , 139 ]. In patients with Sjögren’s syndrome, an autoimmune disease primarily affecting the salivary and lacrimal glands, dysfunction or damage to these glands can lead to reduced saliva and tear production [ 140 ]. Damage to the function of the salivary glands can occur in patients treated with antineoplastic drugs, including cyclophosphamide [ 141 ] and 5-fluorouracil [ 36 ], or with antibiotics, such as metronidazole [ 142 ], or analgesic drugs, such as tramadol [ 143 ].…”

Practical diagnostic tips for the Sjögren Clinic: pearls, myths and mistakes

“…With respect to alcohol intake, patients with SS were less likely to consume alcohol after adjusting for age, sex and education in comparison with the general population (21), suggesting a similar pattern to that observed for smoking (oral discomfort from the intake of alcohol may underlie the lower prevalence in prevalent cases). Alcohol consumption should also be considered in patients already diagnosed with SS who develop parotid swelling during the follow-up, since a recent study (22) has reported that alcohol intake may be associated with an increased risk of parotid swelling. Regardless of the potential "protective" effects of tobacco and alcohol in SS, their negative effects in global health are undeniable and both should be avoided in patients with a suspected disease and in those already diagnosed with SS.…”