title: Quantitative immunohistologic criteria are superior to the lymphocytic focus score criterion for the diagnosis of Sjögren's syndrome.
abstract: OBJECTIVE
  The aim of the present study was to evaluate the diagnostic value of quantitative immunohistologic criteria for Sjögren's syndrome (SS) in labial salivary gland biopsies.
  
  
  METHODS
  Quantitative immunohistologic examination was performed on labial salivary gland biopsy samples from 80 healthy controls, 32 patients with primary SS, 14 patients with secondary SS, 5 with "probable" SS, 36 with keratoconjunctivitis sicca (KCS) with a lymphocytic focus score less than 1 on the lip biopsy, and 18 with rheumatoid arthritis (RA) without clinical evidence of SS.
  
  
  RESULTS
  This is the first study to show that immunohistologic criteria for SS, based on the percentages of IgA-containing and IgG-containing plasma cells, are able to 1) confirm the diagnosis of SS in labial salivary glands of KCS patients in the absence of grade IV lymphocytic adenitis; and 2) distinguish between a grade IV focal lymphocytic adenitis in the labial salivary glands of SS patients and of RA patients without SS.
  
  
  CONCLUSIONS
  Quantitative immunohistologic criteria were shown to be much more sensitive and disease specific than the widely accepted grade IV lymphocytic adenitis criterion, which corresponds to a lymphocytic focus score greater than 1, and these criteria should be included in the international diagnostic criteria for Sjögren's syndrome.
authors.affiliation: Department of Pathology, University Hospital, Nijmegen, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Bodeutsch
authors.forename: P C
authors.initials: PC
authors.lastname: de Wilde
authors.forename: L
authors.initials: L
authors.lastname: Kater
authors.forename: J C
authors.initials: JC
authors.lastname: van Houwelingen
authors.forename: F H
authors.initials: FH
authors.lastname: van den Hoogen
authors.forename: A A
authors.initials: AA
authors.lastname: Kruize
authors.forename: R J
authors.initials: RJ
authors.lastname: Hené
authors.forename: L B
authors.initials: LB
authors.lastname: van de Putte
authors.forename: G P
authors.initials: GP
authors.lastname: Vooijs
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007074:Immunoglobulin G / Q000378:metabolism; D007075:Immunoglobulin M / Q000378:metabolism; D007223:Infant; D008199:Lymphadenitis / Q000473:pathology*; D008875:Middle Aged; D015588:Observer Variation; D010950:Plasma Cells / Q000276:immunology / Q000473:pathology; D012044:Regression Analysis; D012470:Salivary Glands, Minor / Q000276:immunology / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M