Introduction:

Eosinophilic sialodochitis is a rare but emerging disease that can cause salivary gland swelling, eosinophilic-rich mucus plugs and eosinophilic infiltration of the salivary duct. Symptoms reach from itching to severe pain and recurrent salivary duct obstruction. Treatment of eosinophilic sialodochitis comprises sialogogic measures, antihistamines, leukotriene receptor antagonists, oral corticosteroids as well as surgical interventions such as sialendoscopy and corticosteroid irrigation of the salivary duct.

Materials and Methods:

Here, we present a case of a 38-year-old female patient with esosinophilic sialodochitis of the parotid and submandibular ducts refractory to all above-mentioned medical and surgical treatments. In this patient, off-label administration of the anti-IL-5-antibody mepolizumab (100mg as a subcutaneous injection every 4 weeks) was initiated as an individual treatment to reduce quality of life impairing symptoms. Pre-treatment symptoms and treatment response was measured by using disease-specific questionnaires (Chronic Obstructive Sialadenitis Symptoms Questionnaire and Manukau Salivary Symptoms Score).

Results:

In this patient, Mepolizumab treatment significantly reduced symptoms, improved quality of life in contrast to the above-mentioned medical and surgical interventions and reduced necessity of corticosteroid irrigation of the salivary ducts. No severe side effects were observed. Application for defrayal of costs in pending.

Discussion:

Anti-IL-5-antibodies for eosinophilic diseases such as eosinophilic sialodochitis can be a therapeutic option for patients with severe symptoms refractory to other medical or surgical interventions.

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