Salivary gland involvement in patients with chronic pancreatitis

The salivary glands are structurally similar to the exocrine pancreas and m ay be involved in the course of diseases of autoimmune origin (sclerosing c holangitis, ulcerative rectocolitis, primary biliary cirrhosis). For a not- yet-quantified proportion of chronic pancreatitis (CP) cases, a possible au toimmune pathogenesis has been postulated. The aim of the study was to asse ss the frequency of salivary ductal system abnormalities in patients with C P. Fifty-one patients with CP consecutively admitted to our center were stu died (44 men, seven women; mean age, 48.2 +/- 10.8 years). The mean duratio n of disease was 11.7 years (range, 1-37 years); 44 (86%) of 51 patients ha d pancreatic calcifications, 25 (49%) of 51 diabetes, 25 (52%) of 48 steato rrhea, and 32 (63%) of 51 underwent pancreatic surgery. As a control group, we studied 10 patients of whom four with liver cirrhosis (three alcoholic and one posthepatitis; three men, one woman; mean age, 57 +/- 12.5 years), and six with temporomandibular pain (five men and one woman; mean age, 42 /- 10.3 years). The patients were given parotid sialography, the findings b eing read by two independent observers. In two CP patients, parotid sialogr aphy was unsuccessful. Fifteen (31%) of 49 patients and none of the 10 cont rol patients exhibited abnormalities of the glandular ducts compatible with chronic inflammation of the salivary ducts (p = 0.039). None of the CP pat ients had salivary intraductal calcifications. Findings of parotid ductal a bnormalities are frequent in the course of CP and may indicate a common pat hogenetic mechanism, even of an immune type.