Sialoendoscopy in Juvenile Recurrent Parotitis That Could Be Primary Pediatric Sjogren’s Syndrome

Abstract

Parotid swelling often is encountered in the pediatric population, essentially acute and self-limiting, which usually represents viral or bacterial infections. Less common etiologies include juvenile recurrent parotitis (JRP) or pneumoparotid or anatomic abnormalities. Sjögren’s syndrome is common in JRP (40% almost). Levels of suspicion for an autoimmune disorder should be maintained for children affected by JRP, particulary in bilateral glands involvement in order to optimize diagnoses and facilitate treatment. Cytological examination of saliva, which is normally in children is acellular, shows granulocytes, lymphocytes, and in some cases 50% of bacteria. Sialoendoscopy typically shows whitish ductal walls and the presence of stenosis without evidence of solid obstructions and/or mucous membranes. Sialoendoscopic treatment can improve symptoms thanks to local anti-inflammatory therapy and sialoendoscopic washing.