SIALADENOSIS - A PRESENTING SIGN IN BULIMIA

Background: Sialadenosis refers to noninflammatory, often recurrent, e nlargement oi the salivary glands, most frequently the parotids, which is almost always associated with an underlying systemic disorder. The se include diabetes, alcoholism, malnutrition, anorexia nervosa, and b ulimia. It is thought that the various causes of sialadenosis all resu lt in a common pathogenetic effect in that they produce a peripheral a utonomic neuropathy which is responsible for disordered metabolism and secretion, resulting in acinar enlargement. Methods: This paper repor ts a case of sialadenosis as a presenting sign in bulimia and studies the histologic and electron microscopic features of this disease. Resu lts: Light microscopy showed acini which appeared to be larger than no rmal and which were composed of plump pyramidal cells containing promi nent zymogen granules. There was less interstitial fat, and the ducts were widely dispersed. Electron microscopy showed the acinar cells to be packed with membrane-limited, dark secretory granules some of which showed moulding of their outlines. Cellular organelles and nuclei wer e inconspicuous. Conclusions: Management of sialadenosis depends upon identification of the underlying cause, which must then be corrected. In bulimia, the swellings may be refractory to standard treatment moda lities; and parotidectomy may be considered as a last resort to improv e the unacceptable aesthetics. (C) 1998 John Wiley & Sons, Inc.