Clinical significance of minor salivary gland biopsy in patients with idiopathic interstitial pneumonia

Alhamad, Esam H.; Cal, Joseph G; Paramasivam, Muthurajan P.; Alessa, Mohammed; Alrajhi, Nuha N.; Omair, Mohammed A.; Al-Rikabi, Ammar C.; Al-Boukai, Ahmad A.

doi:10.1016/j.rmed.2020.106189

Cited by 9 publications

(2 citation statements)

References 30 publications

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“…Furthermore, we show that a substantial number of our ILD patients have no autoimmune symptoms and/or lack autoantibodies related to pSS; thus, our study confirms the findings of other studies, which have shown that ILD can develop before the onset of pSS, highlighting the importance of a thorough evaluation of patients with ILD of unknown etiology. [ 1 7 8 22 23 24 25 ]…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes in patients with primary Sjogren's syndrome-associated interstitial lung disease

et al. 2021

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BACKGROUND: Diagnosing primary Sjogren's syndrome (pSS)-associated interstitial lung disease (ILD) is complex and can be very challenging. In addition, information about the prognostic factors is limited. AIMS: We aimed to determine the clinical characteristics and prognostic factors that impact pSS-ILD survival. METHODS: This retrospective review included 84 consecutive patients diagnosed with pSS-ILD. The information analyzed included the clinical characteristics, laboratory findings, and physiological and hemodynamic data. Prognostic factors were identified using a Cox proportional hazards regression model. RESULTS: The mean age was 60.5 years, and 61.9% were females. The mean time between the onset of symptoms and diagnosis was 21 months (range, 1–98 months). Minor salivary gland biopsy (MSGB) was positive for pSS in 92.3% of the cohort. Fifty percent of the patients had negative autoimmune serology related to pSS. Based on the available hemodynamic data, 40% had pulmonary hypertension (PH), and 20% had severe PH. During follow-up, acute exacerbation was noted in 38% of the cohort. The 5-year survival rate for all patients was 56%. Male sex, usual interstitial pneumonia pattern, and a reduced forced vital capacity were independent predictors of mortality in the pSS-ILD patients. CONCLUSIONS: A significant delay between the onset of symptoms and diagnosis was noted in our cohort. Importantly, our study highlights the importance of MSGB and emphasizes that clinicians should not rely solely on serological tests to diagnose pSS in ILD patients. The overall survival was poor, and more efforts are needed to diagnose pSS-ILD at an early stage and refer patients to experienced centers.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics and outcomes in patients with primary Sjogren's syndrome-associated interstitial lung disease

et al. 2021

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“…To a large extent, identifying IPAF criteria depends on the effort made to look for CTD features. Nailfold capillaroscopy [26], biopsy of accessory salivary glands [26,30,31] or consultation with a rheumatologist or a dermatologist often identify CTD features that may alter the eventual diagnosis, yet they cannot be easily recommended in all patients with ILD. The decision on how far to search for evidence of an underlying CTD often impacts the eventual diagnosis [32].…”

Section: Inclusion Of Rheumatological Reviewmentioning

confidence: 99%

Interstitial pneumonia with autoimmune features: challenges and controversies

et al. 2021

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The presence of clinical, serological and/or radiological features suggestive, but not confirmatory, of a defined connective tissue disease in patients with interstitial lung disease is a relatively frequent occurrence. In 2015, the European Respiratory Society and the American Thoracic Society proposed classification criteria for the interstitial pneumonia with autoimmune features (IPAF) research entity to capture such patients in a standardised manner, with the intention of nurturing clinical research. This initiative resulted in the publication of several series of IPAF patients, with significant variation between cohorts in clinical characteristics, outcome and the application of IPAF criteria in patient selection. From this increasing body of published work, it has become apparent that revision of IPAF criteria is now required in order to justify the eventual designation of IPAF as a standalone diagnostic term, as opposed to a provisional entity put forward as a basis for clinical research. This review covers the current state of IPAF, conclusions that can and cannot be drawn from the IPAF evidence base, and ongoing uncertainties that require further expert group consideration.

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Bedside labial salivary gland biopsy (LSGBx: Lip biopsy): An update for rheumatologists

Ike

McCoy

2023

Best Practice & Research Clinical Rheumatology

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Clinical significance of minor salivary gland biopsy in patients with idiopathic interstitial pneumonia

Cited by 9 publications

References 30 publications

Clinical characteristics and outcomes in patients with primary Sjogren's syndrome-associated interstitial lung disease

Clinical characteristics and outcomes in patients with primary Sjogren's syndrome-associated interstitial lung disease

Interstitial pneumonia with autoimmune features: challenges and controversies

Bedside labial salivary gland biopsy (LSGBx: Lip biopsy): An update for rheumatologists

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