Causes and risk factors
The exact cause of Mikulicz syndrome is not known. However, studies have shown that it is one form of Sjogren’s syndrome. It is said to be related to immunoglobulin 4 (IgG4). Certain case studies have shown that this condition is commonly associated with certain medical conditions like tuberculosis, Sjogren’s syndrome, Hodgkin’s diseases, lymphosarcoma, etc.
Clinical presentation:
This condition is characterized by swelling of various glands of the body, particularly the glands around the neck; head, eyes, and ears are affected. Painless enlargement of glands occur. The eyes become dry as the production of tears decrease. Various parts of the eyes become inflamed. The patient experiences dryness of mouth. It can also affect lungs, liver, and kidney. It can also lead to complications like nephritis, pancreatitis, and retroperitoneal fibrosis.
Investigations
The diagnosis is done on the basis of the symptoms narrated by the patient and physical examination. There is no particular test for diagnosis. Ophthalmic examination is carried out. Salivary gland biopsy is done. Certain other tests which can be advised are complete blood count. Immunoglobulin levels are measured. Schirmer tear test and sialogram can also be done along with CT scan and MRI. Certain diagnostic criteria have been put forth for diagnosing this condition. It consists of symmetric and persistent swelling of lacrimal gland; either or both the major salivary glands are affected and ruling out of other conditions which mimic the same complaint needs to be done.
Treatment
Mikulicz syndrome is a self-limiting condition and hence no medical intervention is needed. If the patient presents with complaint of pain, then medications for symptomatic relief are prescribed. Aspiration, if needed, may be given. In severe affection, surgical intervention is done.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms.
