Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants.


OBJECTIVE To examine associations between labial salivary gland (LSG) histopathology and other phenotypic features of Sjögren's syndrome (SS). METHODS The database of the Sjögren's International Collaborative Clinical Alliance (SICCA), a registry of patients with symptoms of possible SS as well as those with obvious disease, was used for the present study. LSG biopsy specimens from SICCA participants were subjected to protocol-directed histopathologic assessments. Among the 1,726 LSG specimens exhibiting any pattern of sialadenitis, we compared biopsy diagnoses against concurrent salivary, ocular, and serologic features. RESULTS LSG specimens included 61% with focal lymphocytic sialadenitis (FLS; 69% of which had focus scores of ≥1 per 4 mm²) and 37% with nonspecific or sclerosing chronic sialadenitis (NS/SCS). Focus scores of ≥1 were strongly associated with serum anti-SSA/SSB positivity, rheumatoid factor, and the ocular component of SS, but not with symptoms of dry mouth or dry eyes. Those with positive anti-SSA/SSB were 9 times (95% confidence interval [95% CI] 7.4-11.9) more likely to have a focus score of ≥1 than were those without anti-SSA/SSB, and those with an unstimulated whole salivary flow rate of <0.1 ml/minute were 2 times (95% CI 1.7-2.8) more likely to have a focus score of ≥1 than were those with a higher flow rate, after controlling for other phenotypic features of SS. CONCLUSION Distinguishing FLS from NS/SCS is essential in assessing LSG biopsies, before determining focus score. A diagnosis of FLS with a focus score of ≥1 per 4 mm², as compared to FLS with a focus score of <1 or NS/SCS, is strongly associated with the ocular and serologic components of SS and reflects SS autoimmunity.

DOI: 10.1002/art.30381

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@article{Daniels2011AssociationsBS, title={Associations between salivary gland histopathologic diagnoses and phenotypic features of Sj{\"{o}gren's syndrome among 1,726 registry participants.}, author={Troy E. Daniels and Darren P Cox and Caroline H. Shiboski and Morten Schi\odt and Ava J Wu and Hector Eduardo Lanfranchi and Hisanori Umehara and Yan Zhao and Stephen J. Challacombe and Mi Y Lam and Yvonne G De Souza and Julie Schi\odt and Helena Holm and Patricia A M Bisio and Mariana S Gandolfo and Toshioki Sawaki and Mengtao Li and Wen Zhang and Beni Varghese-Jacob and Per H Ibsen and Alicia Keszler and Nozomu Kurose and Takayuki Nojima and E. W. Odell and Lindsey A . Criswell and Richard Jordan and John S. Greenspan}, journal={Arthritis and rheumatism}, year={2011}, volume={63 7}, pages={2021-30} }