Organ affected: salivary & lacrimal glands

When IgG4-RD affects the glands that make saliva and tears

As previous lessons have discussed, IgG4-related disease (IgG4-RD) can affect many different parts of the body. This chapter will focus on how it affects the salivary glands and lacrimal glands. These glands do quiet, steady work every day that are important for normal functioning.

• Salivary glands make saliva, which helps you chew and swallow, speak comfortably, and protect your teeth.

• Lacrimal glands make tears, which keep the front of the eye smooth and comfortable so vision stays clear.

When IgG4-RD involves these glands, people often notice changes that feel very personal and very visible: fullness under the jaw, swelling near the ear, puffy eyelids, pressure around the eyes, or a sense that your mouth and eyes “just don’t feel right.”

These symptoms can be annoying. They can also be unsettling, because they may look like other illnesses, and because they can affect simple daily routines like eating, reading, driving, or sleeping.

The first clues: swelling under the jaw and around the eyes

In this presentation, Dr. Matthew Baker walks through how IgG4-RD often shows up in the salivary glands (submandibular, parotid, and sometimes sublingual) and the lacrimal glands, with swelling that usually builds slowly and is often bilateral. He also explains the older term Mikulicz disease and why these symptoms can be confused with Sjögren syndrome.

What you’ll learn in this chapter

Lesson 1: Overview of salivary and lacrimal gland involvement
What these glands do normally and how IgG4-RD affects them, including anatomy, common symptoms (swelling, dry eyes/mouth), and clinical implications.

Lesson 2: Patient roundtable
Patient stories that show the range of real-life experiences with gland involvement and how it affects daily routines and emotions.

Lesson 3: Clinician roundtable
How specialists work together (rheumatology, ENT, ophthalmology) to diagnose, treat, and monitor salivary and lacrimal gland disease.

Lesson 4: Common questions
Answers to common questions patients and caregivers ask most, with clear guidance for daily management.

Quiz: Test your knowledge – Chapter 5
A short knowledge check that reinforces the key takeaways from the chapter.

Let’s get started.

References

1. Stone JH, Zen Y, Deshpande V. IgG4-Related Disease. N Engl J Med. 2012;366:539–551.https://www.nejm.org/doi/abs/10.1056/NEJMra1104650

2. ScienceDirect Topics. “IgG4-related sialadenitis.” Elsevier/ScienceDirect. https://www.sciencedirect.com/topics/medicine-and-dentistry/igg4-related-sialadenitis