Syndrome and Mikulic disease

Mikulich disease (synonyms: sarcoid sialosis, Mikulic allergic reticuloepithelial sialosis, lymphomyeloid sialosis, lymphocytic tumor) is named after the doctor J. Miculicz, who in 1892 described the increase in all the large and small salivary glands as well as the lacrimal glands he observed on For 14 months the peasant has 42 years.

The author wrote that the disease began about six months before the start of observation with swelling of the lacrimal glands. The eye gap narrowed, it is difficult to watch with a halo. There were no other subjective sensations. Soon they increased under the mandibular glands, which interfered with talking and eating, and later - and parotid glands. Sight was not disturbed. The enlarged salivary glands had a densely-elastic consistency, were painless, moderately mobile. Saliva in the mouth was observed a lot, the mucous membrane was not changed. The author made a partial resection of the lacrimal glands, which soon again increased to the same size. Only after the complete removal of lacrimal and submaxillary glands did the peasant return to his work and felt well. However, after 2 months he became ill and on the 9th day died of peritonitis. The parotid and small salivary glands, slightly enlarged after the operation, began to decrease rapidly before death and then completely disappeared. In the pathohistological study of the submandibular glands, I. Mikulich established that the entire gland had a normal structure; You could divide it into lobes and stakes. On the cut, the tissue of the gland was different from the normal vascular insufficiency, it had a pale reddish yellow color. The iron had a soft consistency, had a greasy, transparent surface. Microscopically unchanged acini were spread out by a round-celled tissue, cells of which had different sizes. Between them was a thin endoplasmic reticulum. In larger cells, mitosis could be recognized. A similar pattern was observed in the lacrimal glands.

Epidemiology of Myculic disease

This is a rare disease, observed in adults, mainly in women. In childhood it is not noted. It is often diagnosed in patients with blood diseases (lymphogranulomatosis) or is their predecessor.

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Causes of Mikulich's disease

The causes of Mikulich's disease are unknown, a viral infection is suspected, as well as a blood disease (lymphogranulomatosis).

Symptoms of Mikulich's disease

The clinical picture is characterized by a slow and painless significant increase in all salivary and lacrimal glands (as I. Mikulich described in 1892). The skin over the glands in color does not change. When the palpation of the gland is densely elastic consistency. The function of salivary and lacrimal glands, unlike Sjogren's syndrome, does not change. The mucous membrane of the oral cavity in color is not changed. Saliva with the salivary glands mass is released freely. No signs of damage to internal organs are detected.

Diagnosis of Mikulic disease

With Mikulich syndrome, lymphoproliferative changes in the blood system can be detected. Laboratory indicators of urine remain within normal limits. The sialograms determine the signs of interstitial sialadenitis with narrowing of the gland ducts. In biopsies of the salivary and lacrimal glands, a pronounced lymphoid infiltrate is revealed, which compresses the ducts without destroying the basal membranes and replacing the acinar tissue.

Treatment of Mikulich's disease

Treatment of Mikulich's disease (syndrome) is mostly symptomatic. They use X-ray therapy, which gives a temporary effect, after which the salivary glands enlarge again, and the dryness of the oral cavity may persist for a long time. Novocaine outer blockades in the salivary glands, galantamine injections, etc. Are also used for treatment. Treatment is considered effective in the case of a significant decrease in the salivary glands for a long period, lack of xerostomia and exacerbation of sialadenitis.

Prognosis of Mikulich disease

The outlook is unfavorable. Relapse is quite often observed. In the dynamics of observation, various blood diseases or other severe pathological processes in the body are detected.