Beneficial effects of steroid therapy for Mikulicz's disease

Abstract

Sir, Mikulicz's disease (MD) represents a unique condition involving symmetrical enlargement of the lacrimal and salivary glands, the cause of which is unknown. It has been included within the diagnostic criteria for primary Sjögren's syndrome (SS) due to their histological resemblance [1]. However, it is clear that the pathogenesis of MD differs from that of SS because an elevated serum IgG4 concentration and infiltration of abundant plasmacytes with IgG4 into the lacrimal and salivary glands are seen in MD patients [2]. Clinically, MD exhibits good responsiveness to glucocorticoids, showing improvements in not only lacrimal and salivary gland swelling but also secretion. We attempted to objectively document this phenomenon and to serologically evaluate steroid efficacy.