La parotite ricorrente scialectasica nell'infanzia: studio di 10 casi.

Ten children, ranging in age from 10 months to 4 years, presenting with recurrent parotitis, were studied. Main symptoms on presentation were recurrent mono-orbilateral swelling of the parotid gland with mild pain , slight fever and , less frequently, anorexia and asthenia. No pus from Stensen’s duct was observed when pressure was applied to the parotid gland. In all cases sialography disclosed evident diameter changes in the intralobar ducts . The average age of the children at the sialogram investigation was 5 years and 8 months. In six children humoral immunity studies we recarried out including lgG, IgA , IgM, lgE, levels, organ specific and non specific auto-antibodies and C3 complement fraction. The cellular immunity was also investigated including E-rosette test, EAC and membrane immunofluorescence on lymphocytes, and phagocytic activity of PMN in peripheral blood. Two children underwent parotid gland needle biopsy. Therapy was mainly antipyretic and antibiotic; in two cases X ray therapy was employed. As of December 1978, follow - up varied from 12 months to 8 years and 3 months. Complete healing in all patients was not observed , nor was any correlation noticed between severity of the sialogram, frequency of the parotid gland swelling and duration of the disease. Abnormal immunological data are infrequent, poorly significant and not homogeneous, and therefore the hypothesis of an immunological disorder is not supported. The etiology of PRS is not yet clear and only symptomatic therapy is indicated at present. It has been reported that PRS resolves spontaneously with puberty, thus supporting a conservative therapeutic approach. The lack of correlation between the clinical picture and these verity of the sialogram lesion is probably due to the relative a specificity of the X-ray picture as compared to the histologic lesion. Never the less the presence of intralobar sialectasia represents a secure finding for the differential diagnosis with other diseases that may cause periodic swelling of the parotid gland.