Labial salivary gland biopsy in sjögren's syndrome

Abstract

Xerostomia is an unsatisfactory diagnostic criterion for the salivary component of Sjögren's syndrome (SS). To determine the diagnostic usefulness of the presence of focal sialadenitis in labial salivary gland (LSG) biopsy specimens, 362 patients suspected of having SS prospectively underwent a unique LSG biopsy procedure. The pattern and severity of LSG inflammation were compared with measurements of parotid flow rate, and the presence or absence of symptomatic xerostomia, major salivary gland enlargement, keratoconjunctivitis sicca (KCS), and other connective tissue diseases (CTD). LSG biopsy focus scores of >1 correlated more closely with the diagnoses of KCS alone and with KCS plus a CTD than did either reduced parotid flow rate or symptoms of xerostomia (P < 0.0005 and P < 0.05, respectively). Focal sialadenitis in an adequate LSG specimen is an objective criterion and a more disease‐specific feature of SS than xerostomia or any other feature of salivary disease. The salivary component of SS should be redefined as the presence of LSG focal sialadenitis.

Th1 Predominance and Perforin Expression in Minor Salivary Glands from Patients with Primary Sjögren's Syndrome

“…Onset of clinical keratoconjunctivitis and/or xerostomia was estimated on anamnesis about specific symptoms, as described by ECC. Minor salivary gland biopsies were classified as grade I-IV, following Chisholm's classification [23] and focus score according to Daniel's criteria [24].…”

Differential Immunological Aberrations in Patients with Primary and Secondary Sjögren's Syndrome

“…Labial salivary gland biopsy was performed through normal-appearing mucosa inside the lower lip between the mid-line and the commissure [13]. After local anaesthesia a single horizontal 1.5-2 cm incision was made through the mucosal surface.…”

“…The area of salivary gland tissue was determined by using a graticule. The degree of inflammation was determined by focus scoring, a method which provides a semiquantitative assessment of the inflammation [13,14] unlabeled mouse MoAbs, appropriately diluted in TBS containing 4% normal rabbit serum and 4% bovine serum albumin (TBS-BSA). Optimal dilutions of the antibodies were determined by block titrations on normal lymph nodes.…”

Very low-dose cyclosporin treatment of steroid-resistant interstitial pneumonitis associated with Sj�gren's syndrome

“…The Schirmer test was positive (R: 3 ram, L: 2 ram; n > 10), and the Rose Bengal test was also positive. Lip biopsy showed sialoadenitis with infiltrating lymphocytes, findings consistent with a diagnosis of SS (the focus scores 9-12) [20]. Transbronchial lung biopsy showed markedly thickened alveolar septal walls and a prominent lymphocytic infiltrate, findings that were thought to be diagnostic of alveolitis.…”