Reversibility of histological and immunohistological abnormalities in sublabial salivary gland biopsy specimens following treatment with corticosteroids in Sjögren's syndrome.
Sjögren's syndrome (SS) is a chronic autoimmune disease characterised by specific lesions in exocrine glands, so sublabial minor salivary gland biopsy (SLGB) plays an important part in its diagnosis. The extent and composition of the lymphocytic infiltrate in SLGB specimens can be considered as target organ specific parameters. They are quantified after histological and immunohistological examination by a focus score (describing the extent of the infiltrate) and IgA% score (describing the composition of the infiltrate), respectively. However, little is known about the factors that contribute to the extent and composition of the infiltrate and whether these features are reversible as repeated SLGBs are rarely performed. A patient with SS is described who underwent SLGBs before and after treatment with high dose corticosteroids. After treatment there was not only clinical improvement, but also improvement in the histological and immunohistological parameters. Although these findings need to be confirmed in further studies, this suggests that histopathological changes may be reversible in SS. Furthermore, it shows that the potential effects of corticosteroid use should be taken into account when interpreting SLGB specimens. When clinical changes do parallel histological changes, repeated SLGBs might offer a marker for disease activity in patients with SS.
Zandbelt
M M
MM
Department of Rheumatology, University Medical Centre St Radboud, Nijmegen, Netherlands. M.Zandbelt@reuma.azn.nl
van den Hoogen
F H
FH
de Wilde
P C
PC
van den Berg
P J
PJ
Schneider
H G
HG
van de Putte
L B
LB
D000328:Adult; D003520:Cyclophosphamide / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D007150:Immunohistochemistry; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008046:Lip; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D011241:Prednisone / Q000627:therapeutic use*; D012470:Salivary Glands, Minor / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000188:drug therapy* / Q000473:pathology*
D005938:Glucocorticoids; D007070:Immunoglobulin A; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011241:Prednisone