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Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants.
Arthritis Rheum. 2011 Jul; 63(7):2021-30.AR

Abstract

OBJECTIVE

To examine associations between labial salivary gland (LSG) histopathology and other phenotypic features of Sjögren's syndrome (SS).

METHODS

The database of the Sjögren's International Collaborative Clinical Alliance (SICCA), a registry of patients with symptoms of possible SS as well as those with obvious disease, was used for the present study. LSG biopsy specimens from SICCA participants were subjected to protocol-directed histopathologic assessments. Among the 1,726 LSG specimens exhibiting any pattern of sialadenitis, we compared biopsy diagnoses against concurrent salivary, ocular, and serologic features.

RESULTS

LSG specimens included 61% with focal lymphocytic sialadenitis (FLS; 69% of which had focus scores of ≥1 per 4 mm²) and 37% with nonspecific or sclerosing chronic sialadenitis (NS/SCS). Focus scores of ≥1 were strongly associated with serum anti-SSA/SSB positivity, rheumatoid factor, and the ocular component of SS, but not with symptoms of dry mouth or dry eyes. Those with positive anti-SSA/SSB were 9 times (95% confidence interval [95% CI] 7.4-11.9) more likely to have a focus score of ≥1 than were those without anti-SSA/SSB, and those with an unstimulated whole salivary flow rate of <0.1 ml/minute were 2 times (95% CI 1.7-2.8) more likely to have a focus score of ≥1 than were those with a higher flow rate, after controlling for other phenotypic features of SS.

CONCLUSION

Distinguishing FLS from NS/SCS is essential in assessing LSG biopsies, before determining focus score. A diagnosis of FLS with a focus score of ≥1 per 4 mm², as compared to FLS with a focus score of <1 or NS/SCS, is strongly associated with the ocular and serologic components of SS and reflects SS autoimmunity.

Authors+Show Affiliations

University of California, San Francisco, CA, USA. troy.daniels@ucsf.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21480190

Citation

Daniels, Troy E., et al. "Associations Between Salivary Gland Histopathologic Diagnoses and Phenotypic Features of Sjögren's Syndrome Among 1,726 Registry Participants." Arthritis and Rheumatism, vol. 63, no. 7, 2011, pp. 2021-30.
Daniels TE, Cox D, Shiboski CH, et al. Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants. Arthritis Rheum. 2011;63(7):2021-30.
Daniels, T. E., Cox, D., Shiboski, C. H., Schiødt, M., Wu, A., Lanfranchi, H., Umehara, H., Zhao, Y., Challacombe, S., Lam, M. Y., De Souza, Y., Schiødt, J., Holm, H., Bisio, P. A., Gandolfo, M. S., Sawaki, T., Li, M., Zhang, W., Varghese-Jacob, B., ... Greenspan, J. S. (2011). Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants. Arthritis and Rheumatism, 63(7), 2021-30. https://doi.org/10.1002/art.30381
Daniels TE, et al. Associations Between Salivary Gland Histopathologic Diagnoses and Phenotypic Features of Sjögren's Syndrome Among 1,726 Registry Participants. Arthritis Rheum. 2011;63(7):2021-30. PubMed PMID: 21480190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants. AU - Daniels,Troy E, AU - Cox,Darren, AU - Shiboski,Caroline H, AU - Schiødt,Morten, AU - Wu,Ava, AU - Lanfranchi,Hector, AU - Umehara,Hisanori, AU - Zhao,Yan, AU - Challacombe,Stephen, AU - Lam,Mi Y, AU - De Souza,Yvonne, AU - Schiødt,Julie, AU - Holm,Helena, AU - Bisio,Patricia A M, AU - Gandolfo,Mariana S, AU - Sawaki,Toshioki, AU - Li,Mengtao, AU - Zhang,Wen, AU - Varghese-Jacob,Beni, AU - Ibsen,Per, AU - Keszler,Alicia, AU - Kurose,Nozomu, AU - Nojima,Takayuki, AU - Odell,Edward, AU - Criswell,Lindsey A, AU - Jordan,Richard, AU - Greenspan,John S, AU - ,, PY - 2011/4/12/entrez PY - 2011/4/12/pubmed PY - 2011/9/2/medline SP - 2021 EP - 30 JF - Arthritis and rheumatism JO - Arthritis Rheum VL - 63 IS - 7 N2 - OBJECTIVE: To examine associations between labial salivary gland (LSG) histopathology and other phenotypic features of Sjögren's syndrome (SS). METHODS: The database of the Sjögren's International Collaborative Clinical Alliance (SICCA), a registry of patients with symptoms of possible SS as well as those with obvious disease, was used for the present study. LSG biopsy specimens from SICCA participants were subjected to protocol-directed histopathologic assessments. Among the 1,726 LSG specimens exhibiting any pattern of sialadenitis, we compared biopsy diagnoses against concurrent salivary, ocular, and serologic features. RESULTS: LSG specimens included 61% with focal lymphocytic sialadenitis (FLS; 69% of which had focus scores of ≥1 per 4 mm²) and 37% with nonspecific or sclerosing chronic sialadenitis (NS/SCS). Focus scores of ≥1 were strongly associated with serum anti-SSA/SSB positivity, rheumatoid factor, and the ocular component of SS, but not with symptoms of dry mouth or dry eyes. Those with positive anti-SSA/SSB were 9 times (95% confidence interval [95% CI] 7.4-11.9) more likely to have a focus score of ≥1 than were those without anti-SSA/SSB, and those with an unstimulated whole salivary flow rate of <0.1 ml/minute were 2 times (95% CI 1.7-2.8) more likely to have a focus score of ≥1 than were those with a higher flow rate, after controlling for other phenotypic features of SS. CONCLUSION: Distinguishing FLS from NS/SCS is essential in assessing LSG biopsies, before determining focus score. A diagnosis of FLS with a focus score of ≥1 per 4 mm², as compared to FLS with a focus score of <1 or NS/SCS, is strongly associated with the ocular and serologic components of SS and reflects SS autoimmunity. SN - 1529-0131 UR - https://www.unboundmedicine.com/medline/citation/21480190/Associations_between_salivary_gland_histopathologic_diagnoses_and_phenotypic_features_of_Sjögren's_syndrome_among_1726_registry_participants_ L2 - https://doi.org/10.1002/art.30381 DB - PRIME DP - Unbound Medicine ER -