Advertisement

The role of minor salivary glands’ biopsy in the diagnosis of Sjögren's syndrome and other systemic diseases

Published:August 09, 2021DOI:https://doi.org/10.1016/j.ejim.2021.07.012

      Highlights

      • Minor salivary gland biopsy is a minimally invasive and safe diagnostic procedure.
      • It is mainly used for the diagnosis of Sjögren's syndrome.
      • Sjögren's syndrome has an important morbility and potencial for serious complications.
      • Minor salivary gland biopsy allows to identify presence of lymphocytic sialadenitis.
      • Histological confirmation increase the possibility of Sjögren's syndrome diagnosis.

      Abstract

      Background

      The minor salivary glands’ biopsy is a minimally invasive procedure used for the diagnosis of Sjögren's syndrome. Its significance has also been reported in other inflammatory/infiltrative diseases. The objectives are to investigate its use in the diagnosis of Sjögren's syndrome, as well as to evaluate its role in the diagnosis of amyloidosis and sarcoidosis.

      Methods

      A retrospective analysis was carried out on patients who underwent minor salivary glands’ biopsies between April of 2014 and December of 2017.

      Results

      A total of 173 patients were identified. Of the patients with suspected Sjögren's syndrome, in 40% of the cases there was evidence of lymphocytic sialadenitis. The antibodies against SSA, antinuclear antibodies and the Rheumatoid Factor correlated significantly with the presence of lymphocytic sialadenitis. The result of the minor salivary glands’ biopsies allowed an increase of 12.4% of patients who met the criteria defined by the American – European Consensus Group. Of the patients with suspected amyloidosis (25%), the biopsies were positive in 4 patients.

      Conclusion

      The minor salivary glands’ biopsy is a simple procedure with effectiveness in the diagnosis of Sjögren's syndrome and amyloidosis. In this study, its use increased the number of patients who met the Sjögren's syndrome classification criteria. It also appears to be useful in the diagnosis of amyloidosis.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Fox R.I.
        Sjögren Syndrome.
        Lancet. 2005; 366: 321-331https://doi.org/10.1016/S0140-6736(05)66990-5
        • Reksten T.R.
        • Jonsson M.V.
        Sjögren's syndrome: an update on epidemiology and current insights on pathophysiology.
        Oral Maxillofac Surg Clin North Am. 2014; 26: 1-12https://doi.org/10.1016/j.coms.2013.09.002
        • Qin B.
        • Wang J.
        • Yang Z.
        • Yang M.
        • Ma N.
        • Huang F.
        • et al.
        Epidemiology of primary Sjögren's syndrome: a systematic review and meta-analysis.
        Ann Rheum Dis. 2015; 74 (Published Online First: 17 June 2014): 1983-1989https://doi.org/10.1136/annrheumdis-2014-205375
        • Caporali R.
        • Bonacci E.
        • Epis O.
        • Bobbio-Pallavicini F.
        • Morbini P.
        • Montecucco C.
        Safety and usefulness of minor salivary gland biopsy: retrospective analysis of 502 procedures performed at a single center.
        Arthritis Rheum. 2008; 59: 714-720https://doi.org/10.1002/art.23579
        • Chisholm D.M.
        • Mason D.K.
        Labial salivary gland biopsy in Sjögren's disease.
        J Clin Pathol. 1968; 21: 656-660https://doi.org/10.1136/jcp.21.5.656
        • Guellec D.
        • Cornec D.
        • Jousse-Joulin S.
        • Marhadour T.
        • Marcorelles P.
        • Pers J.O.
        • et al.
        Diagnostic value of labial minor salivary gland biopsy for Sjögren's syndrome: a systematic review.
        Autoimmun Rev. 2012; 12: 416-420https://doi.org/10.1016/j.autrev.2012.08.001
      1. Sacsaquispe S.J., Antúnez-de Mayolo E.A., Vicetti R., Delgado W.A.. Detection of AA-type amyloid protein in labial salivary glands. Med Oral Patol Oral Cir Bucal 2011; 16(2): 149-52. 10.4317/medoral.16.e149.

        • Czeyda-Pommersheim F.
        • Hwang M.
        • Chen S.S.
        • Strollo D.
        • Fuhrman C.
        • Bhalla S.
        Amyloidosis: modern cross-sectional imaging.
        Radiographics. 2015; 35: 1381-1392https://doi.org/10.1148/rg.2015140179
        • Mollee P.
        • Renaut P.
        • Gottlieb D.
        • Goodman H.
        How to diagnose amyloidosis.
        Intern Med J. 2014; 44: 7-17https://doi.org/10.1111/imj.12288
        • Blaise P.
        • Fardeau C.
        • Chapelon C.
        • Bodaghi B.
        Le Hoang P. Minor salivary gland biopsy in diagnosing ocular sarcoidosis.
        Br J Ophthalmol. 2011; 95: 1731-1734https://doi.org/10.1136/bjophthalmol-2011-300129
        • Baker K.R.
        • Rice L.
        The amyloidoses: clinical features, diagnosis and treatment.
        Methodist Debakey Cardiovasc J. 2012; 8: 3-7https://doi.org/10.14797/mdcj-8-3-3
        • Real de Asúa D.
        • Costa R.
        • Galván J.M.
        • Filigheddu M.T.
        • Trujillo D.
        • Cadiñanos J.
        Systemic AA amyloidosis: epidemiology, diagnosis, and management.
        Clin Epidemiol. 2014; 6: 369-377https://doi.org/10.2147/CLEP.S39981
        • Stefanski A.L.
        • Tomiak C.
        • Pleyer U.
        • Dietrich T.
        • Burmester G.R.
        • Dörner T.
        The diagnosis and treatment of Sjögren's syndrome.
        Dtsch Arztebl Int. 2017; 114: 354-361https://doi.org/10.3238/arztebl.2017.0354