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Establishing guidelines for the role of minor salivary gland biopsy in clinical practice for Sjögren's syndrome.
J Rheumatol. 1998 Feb; 25(2):247-53.JR

Abstract

OBJECTIVE

To evaluate the predictive value of clinical variables for the finding of a positive minor salivary gland biopsy (focus score > or = 2) in patients investigated for Sjögren's syndrome (SS).

METHODS

One hundred twenty-one patients with sicca symptoms were referred to a multidisciplinary SS clinic in a tertiary hospital. Each patient was evaluated on protocol and labial salivary gland (LSG) biopsy was obtained. Using the San Diego criteria as a model, patient data were subjected to a cross sectional analysis on an algorithm to determine when the LSG biopsy would be most useful for determining the diagnosis of SS in clinical practice.

RESULTS

Eighty-four patients had sufficient data to be included in the study. Forty patients had LSG biopsy with focus score < 2 and 44 had focus score > or = 2. Twenty-three patients had objective evidence of sicca and positive serology according to criteria standards. Eighteen of these had a positive biopsy (78%). The remaining 5 patients had many extraglandular features suggestive of SS, and the biopsies appeared to add little practical information. Patients with incomplete criteria for sicca could be diagnosed as possible SS (3 of 4 criteria) with a positive biopsy in 14 of 18 cases. The finding of anti-Ro or anti-La positivity in patients with incomplete criteria for sicca predicted a positive LSG biopsy in 85.7% of such cases. Patients with incomplete sicca and negative anti-Ro and anti-La had a negative LSG biopsy in 82% of cases.

CONCLUSION

The LSG biopsy is most necessary in patients who have partial San Diego criteria for sicca and positive anti-Ro or anti-La antibody. Where SS is not reasonably suspected, or where the diagnosis is clinically obvious, the LSG biopsy adds little useful clinical information.

Authors+Show Affiliations

Division of Rheumatology, The Toronto Hospital, University of Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9489815

Citation

Lee, M, et al. "Establishing Guidelines for the Role of Minor Salivary Gland Biopsy in Clinical Practice for Sjögren's Syndrome." The Journal of Rheumatology, vol. 25, no. 2, 1998, pp. 247-53.
Lee M, Rutka JA, Slomovic AR, et al. Establishing guidelines for the role of minor salivary gland biopsy in clinical practice for Sjögren's syndrome. J Rheumatol. 1998;25(2):247-53.
Lee, M., Rutka, J. A., Slomovic, A. R., McComb, J., Bailey, D. J., & Bookman, A. A. (1998). Establishing guidelines for the role of minor salivary gland biopsy in clinical practice for Sjögren's syndrome. The Journal of Rheumatology, 25(2), 247-53.
Lee M, et al. Establishing Guidelines for the Role of Minor Salivary Gland Biopsy in Clinical Practice for Sjögren's Syndrome. J Rheumatol. 1998;25(2):247-53. PubMed PMID: 9489815.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Establishing guidelines for the role of minor salivary gland biopsy in clinical practice for Sjögren's syndrome. AU - Lee,M, AU - Rutka,J A, AU - Slomovic,A R, AU - McComb,J, AU - Bailey,D J, AU - Bookman,A A, PY - 1998/3/7/pubmed PY - 1998/3/7/medline PY - 1998/3/7/entrez SP - 247 EP - 53 JF - The Journal of rheumatology JO - J Rheumatol VL - 25 IS - 2 N2 - OBJECTIVE: To evaluate the predictive value of clinical variables for the finding of a positive minor salivary gland biopsy (focus score > or = 2) in patients investigated for Sjögren's syndrome (SS). METHODS: One hundred twenty-one patients with sicca symptoms were referred to a multidisciplinary SS clinic in a tertiary hospital. Each patient was evaluated on protocol and labial salivary gland (LSG) biopsy was obtained. Using the San Diego criteria as a model, patient data were subjected to a cross sectional analysis on an algorithm to determine when the LSG biopsy would be most useful for determining the diagnosis of SS in clinical practice. RESULTS: Eighty-four patients had sufficient data to be included in the study. Forty patients had LSG biopsy with focus score < 2 and 44 had focus score > or = 2. Twenty-three patients had objective evidence of sicca and positive serology according to criteria standards. Eighteen of these had a positive biopsy (78%). The remaining 5 patients had many extraglandular features suggestive of SS, and the biopsies appeared to add little practical information. Patients with incomplete criteria for sicca could be diagnosed as possible SS (3 of 4 criteria) with a positive biopsy in 14 of 18 cases. The finding of anti-Ro or anti-La positivity in patients with incomplete criteria for sicca predicted a positive LSG biopsy in 85.7% of such cases. Patients with incomplete sicca and negative anti-Ro and anti-La had a negative LSG biopsy in 82% of cases. CONCLUSION: The LSG biopsy is most necessary in patients who have partial San Diego criteria for sicca and positive anti-Ro or anti-La antibody. Where SS is not reasonably suspected, or where the diagnosis is clinically obvious, the LSG biopsy adds little useful clinical information. SN - 0315-162X UR - https://www.unboundmedicine.com/medline/citation/9489815/Establishing_guidelines_for_the_role_of_minor_salivary_gland_biopsy_in_clinical_practice_for_Sjögren's_syndrome_ L2 - https://medlineplus.gov/sjogrenssyndrome.html DB - PRIME DP - Unbound Medicine ER -