Sialosis, also known as sialadenosis, represents a bilateral enlargement of the parotid gland that is multifactorial in its etiology (Table 6.3). It is not commonly associated with an autoimmune phenomenon, as is the case for Sjogren's syndrome and sarcoidosis, although it can easily be confused with these two pathologic processes due to its clinical presentation (Figure 6.14). Quite commonly, sialo-sis is caused by nutritional disturbances such as alcoholism, bulimia, or in the rare case of achalasia (Figure 6.15). Chronic alcoholism with or without
Malnutritional sialosis Achalasia Bulemia Alcoholism Hormonal sialosis Sex hormonal sialosis Diabetic sialosis Thyroid sialosis
Pituitary and adrenocortical disorders Neurohumoral sialosis Peripheral neurohumoral sialosis Central neurogenous sialosis Dysenzymatic sialosis Hepatogenic sialosis Pancreatogenic (exocrine) sialosis Nephrogenic sialosis Dysproteinemic sialosis Mucoviscidosis Drug-induced sialosis
From Werning 1991.
Figure 6.15. The fluoroscopic images of the barium swallow performed in the patient in Figure 6.14. The characteristic "bird's beak" deformity is noted, reflective of failure of the lower esophageal sphincter to relax. This is diagnostic of achalasia.
cirrhosis results in asymptomatic enlargement of the parotid glands in 30-80% of these patients (Regezi, Sciubba, and Jordan 2003). In such cases, parotid enlargement has been attributed to protein deficiency. In diabetes mellitus, the mechanism of acinar hypertrophy associated with this condition is unknown. Due to the numerous causes of sialosis, as well as a large number of diagnoses that can clinically resemble sialosis, the patient's history is paramount in such cases so as to properly initiate the diagnostic process. In addition, the treatment for these disorders differs significantly.
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Alcoholism is something that can't be formed in easy terms. Alcoholism as a whole refers to the circumstance whereby there's an obsession in man to keep ingesting beverages with alcohol content which is injurious to health. The circumstance of alcoholism doesn't let the person addicted have any command over ingestion despite being cognizant of the damaging consequences ensuing from it.