Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

Pijpe, J.; Kalk, W.; Wal, Jacqueline E. van der; Vissink, Arjan; Kluin, Philippus; Roodenburg, Jan; Bootsma, Hendrika; Kallenberg, Cornelis; Spijkervet, Frederik

doi:10.1093/rheumatology/kel266

Cited by 174 publications

(166 citation statements)

References 27 publications

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“…Despite lack of a single assessment that can be used as "gold standard" for pSS diagnosis, lower lip gland biopsy has primary value in the diagnosis. Pijpe et al 22 has found that the sensitivity and specificity of lower lip gland biopsy in the diagnosis of pSS were 78% and 86%, and Baeteman and colleagues 23 reported that its sensitivity was 75% and specificity was 100%. In this study, most biopsies showed inflamed salivary glands with cell infiltration, and grade 3 and 4 accounted for 58.5%.…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profiles of primary Sjogren's syndrome in a Chinese population: A retrospective analysis of 315 patients

et al. 2015

Int J of Rheum Dis

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Aim: To assess the clinical and laboratory features of primary Sjogren's syndrome (pSS) in a large teaching hospital in China.Methods: Three hundred and fifteen pSS patients diagnosed according to American-European Classification Criteria and consecutively admitted to Anhui Provincial Hospital from 1 January 1999 to 30 September 2012 were retrospectively selected in this study. Results:The median age was 46.8 AE 14.4 years (range 13-83 years) and the majority of patients were female (96.5%). The common clinical features at initial presentations were dry mouth (50.2%), dry eyes (31.4%) and joint pain (24.8%); 92.6% of patients had positive anti-SSA antibody and 49.2% patients had positive anti-SSB antibody. One hundred and eighteen patients underwent labial salivary gland biopsy. According to Chisholm grading criteria, grade 3 to 4 was present in 58.5% of the patients. The frequency of interstitial lung disease (ILD) occurred (20.9%) in the patients with systemic extraglandular manifestations. The patients with ILD were frequently associated with positive anti-SSA (P = 0.005) and low levels of C3. The most common impairment of lung function was small airway function abnormalities. Sixty-six pSS patients with ILD (pSS-ILD) were diagnosed with high-resolution computed tomography and treated with corticosteroids and/or immunosuppressants, in which 18 patients had improved pulmonary function.Conclusion: Labial salivary gland biopsy and anti-nuclear antibodies spectrum were important to the diagnosis of pSS. The pSS patients had high percentage of ILD, especially small airway function abnormalities. The combination of corticosteroids and immunosuppressants appears to be effective in treatment of pSS patients with ILD.

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Section: Discussionmentioning

confidence: 99%

Clinical and laboratory profiles of primary Sjogren's syndrome in a Chinese population: A retrospective analysis of 315 patients

et al. 2015

Int J of Rheum Dis

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“…These patients fulfilled the 2002 American-European criteria (20) and the recently published American College of Rheumatology criteria for pSS (21). Inclusion criteria of the pSS patients used in this study were stimulated whole saliva secretion flow of .0.15 ml/min, presence of autoantibodies (IgM rheumatoid factor of $10 kIU/l in combination with anti-SS-A and/or anti-SS-B autoantibodies), and a salivary parotid gland biopsy (obtained #12 mo before inclusion) showing characteristic features for SS (22). The five pSS patients were treated with RTX as described before (7).…”

Section: Patientsmentioning

confidence: 99%

Ig Gene Analysis Reveals Altered Selective Pressures on Ig-Producing Cells in Parotid Glands of Primary Sjögren’s Syndrome Patients

Hamza

Hershberg

Kallenberg

et al. 2015

The Journal of Immunology

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In this study, we sought to understand the selective pressures shaping the Ig-producing cell repertoire in the parotid glands of primary Sjögren’s syndrome (pSS) patients before and after rituximab treatment (RTX). In particular, we evaluated the role of potential N-glycosylation motifs acquired by somatic hypermutation (ac-Nglycs) within Ig H chain V region (IGHV) genes as alternative selective pressures for B cells in pSS. Five pSS patients received RTX. Sequential parotid salivary gland biopsies were taken before RTX, at 12 wk and at 36–52 wk after treatment. Parotid biopsies from four non-pSS patients served as controls. Sequence analysis was carried out on the IgA and IgG RNA transcripts expressing IGHV3 genes in all parotid biopsies. Both IgG and IgA sequences from pSS patients exhibited no evidence for positive Ag-driven selection pressure in their CDRs in contrast to non-pSS controls. The prevalence of IgG sequences with ac-Nglycs was significantly higher in pSS patients than in non-pSS controls. Selection pressures shaping the IgG and IgA repertoire within pSS patients’ parotid glands are distinct from those in non-pSS controls, with very little evidence for positive (auto)antigen selection. The higher prevalence of ac-Nglycs on pSS-IgG compared with non-pSS IgG indicates that ac-Nglycs could be an alternative form of selection pressure. We speculate that B cell hyperproliferation within parotid glands of pSS patients may result from Ag-independent interactions such as that between glycosylated B cell receptors and lectins within the microenvironment rather than (auto)antigen-specific stimulation. Our study brings a new perspective into research on pSS.

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“…The parotid gland biopsy does not result in loss of motor function or permanent sensory loss, while labial biopsy led to permanent sensory loss in 6% of the patients. Pijpe, et al 16 . concluded that the diagnostic potential of the parotid biopsy is comparable with that of the labial biopsy in the diagnosis of SS, additionally it offers the potential of detecting malignant lymphomas.…”

Section: Discussionmentioning

confidence: 99%

A comparison of diagnostic tools for Sjögren syndrome, with emphasis on sialography, histopathology, and ultrasonography

Obinata

Sato

Ohmori

et al. 2010

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, an

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ABSTRACT.Objective. The present study examined the reliability and correlation of sialography, salivary gland biopsy, and ultrasonography for Sjögren's syndrome(SS), and evaluated the usefulness of ultrasonography as a diagnostic tool for SS in comparison with sialography and histopathology.Methods. Seventy-three patients who underwent sialography, ultrasonography, and salivary gland biopsy were included in this study. The study evaluated the diagnostic reliability and correlation of each kind of examination with SS.Results. There was a statistically significant difference in the sensitivities of sialography and histopathology, in the specificities of sialography and ultrasonography, and in the accuracies of sialography and both of ultrasonography and histopathology. The correlation coefficient (r) between sialography and ultrasonography was significantly higher than the others and indicated a good correlation.Conclusions. Ultrasonography can be used as a diagnostic tool for SS with its advantage of non-invasiveness and facility.

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Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

Abstract: A parotid biopsy has a diagnostic potential comparable with that of a labial biopsy in the diagnosis of pSS, and may be associated with less morbidity.

Cited by 174 publications

References 27 publications

Clinical and laboratory profiles of primary Sjogren's syndrome in a Chinese population: A retrospective analysis of 315 patients

Clinical and laboratory profiles of primary Sjogren's syndrome in a Chinese population: A retrospective analysis of 315 patients

Ig Gene Analysis Reveals Altered Selective Pressures on Ig-Producing Cells in Parotid Glands of Primary Sjögren’s Syndrome Patients

A comparison of diagnostic tools for Sjögren syndrome, with emphasis on sialography, histopathology, and ultrasonography

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