Sjögren's syndrome in the community: can serology replace salivary gland biopsy?
BACKGROUND
It is relatively difficult in a community setting to perform salivary gland biopsy or reliable diagnostic tests for salivary gland involvement in a patient suspected to suffer from Sjögren's syndrome (SS).


OBJECTIVE
To investigate whether anti-Ro/La antibodies are a good substitute for salivary gland biopsy in community patients suspected to suffer from SS.


METHODS
Forty-one patients suspected as having SS due to dry eyes and mouth, articular complaints, and/or serological findings were examined for the presence of anti-Ro/La, and underwent minor salivary gland biopsy.


RESULTS
Sixteen patients (39%) were classified as primary SS by the American-European Consensus Group criteria. Twelve subjects had anti-Ro/La antibodies and 11 subjects in this group had positive biopsy findings. Of 29 patients without anti-Ro/La antibodies, only four manifested positive biopsy findings. A significant association was found between the presence of anti-Ro/La antibodies and positive salivary gland findings characteristic for SS (p<0.0001, Fisher's exact test).


CONCLUSIONS
These findings tend to support the suggestion that a patient suspected to suffer from SS in a community setting may be first tested for the presence of anti-Ro/La antibodies to confirm the diagnosis. Only those with a negative result for the presence of anti-Ro/La antibodies need to be referred for salivary gland biopsy.
Kessel
Aharon
A
Division of Allergy and Clinical Immunology, Bnai Zion Medical Center, 47 Golomb Street, P.O. Box 4940, Haifa, 31048, Israel. aharon.kessel@b-zion.org.il
Toubi
Elias
E
Rozenbaum
Michael
M
Zisman
Devy
D
Sabo
Edmond
E
Rosner
Itzhak
I
D000974:Antibodies, Antinuclear / Q000097:blood*; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D003153:Community Health Services; D005260:Female; D006801:Humans; D007557:Israel; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012469:Salivary Glands / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000097:blood / Q000175:diagnosis*
D000974:Antibodies, Antinuclear; D015415:Biomarkers; C035356:SS-A antibodies; C035357:SS-B antibodies