Sialometry and sialochemistry: diagnostic tools for Sjogren's syndrome

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Sialometry and sialochemistry: diagnostic tools for Sjogren's syndrome.

Kalk WW, Vissink A, Spijkervet FK, Bootsma H, Kallenberg CG, Nieuw

Amerongen AV.

Department of Oral and Maxillofacial Surgery, University Hospital

Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.

w.w.i.kalk@...

BACKGROUND: The common occurrence of xerostomia in Sjogren's syndrome

(SS) as well as the easy accessibility of saliva supports the use of

sialometry and sialochemistry in the diagnosis of SS. Collection and

analysis of whole saliva (oral fluid) is currently the routine technique

for sialometry, despite the fact that it is rather inaccurate and

impure. OBJECTIVE: To assess the value of glandular sialometry and

sialochemistry as diagnostic instruments in SS. METHODS: In a group of

100 consecutive patients referred for diagnosis of SS, glandular

secretory flow rates and a spectrum of salivary components (sodium,

potassium, chloride, calcium, phosphate, urea, amylase, total protein)

were assessed. The patients were classified as positive or negative for

SS according to the revised European classification criteria. RESULTS:

Patients with SS differed clearly from those who tested negative for SS,

showing lower submandibular/sublingual (SM/SL) flow rates and an

appreciably changed salivary composition of parotid and SM/SL saliva.

Besides changes in salivary flow rate and composition, distinct

sialometric profiles were observed, characteristic of either early or

late salivary manifestation of SS, or of the xerogenic side effects of

medication. CONCLUSIONS: Glandular sialometry and sialochemistry are not

only useful tools for differentiating SS from other salivary gland

disease in clinical practice, but they also have great potential as

diagnostic criteria for SS, showing distinct sialometric and

sialochemical changes as well as profiles. Being simple, safe

(non-invasive), and sensitive (early disease detection), they have three

major advantages over other oral tests for SS.