The minor salivary gland biopsy as a diagnostic tool for Sjogren syndrome.
OBJECTIVE
In suspected cases of Sjogren syndrome (SS), patients are often referred for a labial minor salivary gland biopsy. However, studies have shown this test to be unreliable. Pathologic misinterpretation and immunosuppressive medications may affect the results of the biopsy. As a result, it is best to perform this procedure only when necessary. The purpose of the current study was to review clinical signs and symptoms of patients who underwent a lip biopsy to determine which patients benefited most from this procedure.


METHODS
Retrospective review.


METHODS
A retrospective chart review of patients referred to otolaryngology for a lip biopsy for the diagnosis of SS.


RESULTS
Joint pain, salivary gland swelling, and abnormal serology (anti-Sjogren syndrome A/anti-Sjogren syndrome B) were more prevalent in the positive lip biopsy group (grade = 3 or 4). Out of the 12 patients who had both sicca symptoms and positive serology, nine (75%) had a grade = 4. Presence of sicca symptoms and positive serology were predictive of a positive biopsy (P = .017). Excluding those patients who were on immunosuppression for more than 6 weeks prior to the biopsy, the correlation became stronger (P = .011).


CONCLUSIONS
In this study, clinical presentation of sicca symptoms and positive serology reliably predicted the results of a lip biopsy. The results of this study suggest that patients with clear criterion for SS may not require a lip biopsy, especially those patients on immunosuppression. When physicians suspect SS, a thorough clinical and laboratory examination is necessary to determine if a patient will benefit from a minor salivary gland biopsy.
Bamba
Ravinder
R
Pritzker School of Medicine, University of Chicago, Chicago, Illinois, U.S.A.
Sweiss
Nadera J
NJ
Langerman
Alexander J
AJ
Taxy
Jerome B
JB
Blair
Elizabeth A
EA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D008046:Lip / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012470:Salivary Glands, Minor / Q000473:pathology*; D012859:Sjogren's Syndrome / Q000175:diagnosis*; D055815:Young Adult