Eosinophilic Sialodochitis is an uncommon condition affecting one or more major salivary glands.
Synonyms: Kussmaul's disease, chronic sialodochitis with eosinophilia
Cardinal features of Baer et al:
(1) recurrent paroxysms of major salivary gland swelling
(2) numerous eosinophils in salivary duct mucus plugs
(3) peripheral blood eosinophilia with elevated IgE concentrations
(4) associated atopic disease
(5) ductal dilatation and occasional focal narrowing of the major salivary gland ducts
(6) periductal inflammation rich in eosinophils and lymphocytes
(7) periductal fibrosis
(8) exclusion of IgG4-related disease
where:
• Charcot-Leyden crystals may be seen in the mucus plugs.
• Symptoms may become worse at meal-time.
• Most patients will be atopic with elevated total serum IgE but some are not,. Some patients may have total serum IgG concentration within the normal range while showing elevations in specific IgG to aeroallergens.
Criteria of Carey et al:
(1) presence of eosinophils in aspirated ductal contents
(2) intermittent swelling of one or more major salivary glands
(3) one or more of the following:
(3a) pruritis in the skin overlying the affected gland
(3b) pain in the affected gland
(3c) expression of string-like mucus plugs
(4) exclusion of other causes of salivary gland swelling with eosinophils (Kimura disease; eosinophilic granulomatosis with polyangiitis, etc)
