C M Wise1, R D Woodruff. 1. Department of Internal Medicine, Medical College of Virginia, Richmond 23298-0647.
Abstract
OBJECTIVE: To correlate presenting features and indication for biopsy with results in patients undergoing minor salivary gland biopsy for the diagnosis of primary Sjögren's syndrome (SS). METHODS: The charts of 187 patients undergoing minor salivary gland biopsy for primary SS over a 9-year period were reviewed. RESULTS: 76 patients had a focus score > 1, 111 had a focus score < or = 1. No difference between the 2 groups was noted in most features, including frequency of symptomatic dry eyes or mouth, or Schirmer test results. Patients with focus score > 1 had significant increases in frequency of salivary gland swelling (25 vs 9%), antinuclear antibodies > 1:100 (68 vs 32%), rheumatoid factor > 1:160 (63 vs 22%), anti-SSA (46 vs 9%), anti-SSB (32 vs 4%), or any serologic marker (87 vs 46%). Abnormal biopsies were more frequent in those biopsied for serologic abnormalities (53%) than for sicca symptoms (33%) or systemic illness (29%). CONCLUSION: Serologic markers are better predictors of results than clinical features in patients undergoing minor salivary gland biopsy for primary SS. The frequency of a positive biopsy is increased in patients in whom unexplained serologic markers are being evaluated.
OBJECTIVE: To correlate presenting features and indication for biopsy with results in patients undergoing minor salivary gland biopsy for the diagnosis of primary Sjögren's syndrome (SS). METHODS: The charts of 187 patients undergoing minor salivary gland biopsy for primary SS over a 9-year period were reviewed. RESULTS: 76 patients had a focus score > 1, 111 had a focus score < or = 1. No difference between the 2 groups was noted in most features, including frequency of symptomatic dry eyes or mouth, or Schirmer test results. Patients with focus score > 1 had significant increases in frequency of salivary gland swelling (25 vs 9%), antinuclear antibodies > 1:100 (68 vs 32%), rheumatoid factor > 1:160 (63 vs 22%), anti-SSA (46 vs 9%), anti-SSB (32 vs 4%), or any serologic marker (87 vs 46%). Abnormal biopsies were more frequent in those biopsied for serologic abnormalities (53%) than for sicca symptoms (33%) or systemic illness (29%). CONCLUSION: Serologic markers are better predictors of results than clinical features in patients undergoing minor salivary gland biopsy for primary SS. The frequency of a positive biopsy is increased in patients in whom unexplained serologic markers are being evaluated.