RESEARCH - Parotid gland biopsy in the diagnosis of patients with primary Sjogren's syndrome

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Rheumatology (Oxford). 2007 Feb;46(2):335-41. Epub 2006 Aug 5.

Parotid gland biopsy compared with labial biopsy in the diagnosis of

patients with primary Sjogren's syndrome.

Department of Rheumatology and Clinical Immunology, University Medical

Center Groningen, University of Groningen, PO-Box 30.001, 9700 RB Groningen,

The Netherlands. c.g.m.kallenberg@....

OBJECTIVE: To assess the value of the parotid biopsy as a diagnostic tool

for primary Sjogren's syndrome (pSS), and to compare the parotid biopsy and

the labial biopsy with regard to diagnostic value and biopsy-related

morbidity. METHODS: In 15 consecutive patients with pSS and 20 controls, the

parotid biopsy was assessed as a diagnostic tool based on the presence of

lymphocytic foci, benign lymphoepithelial lesions and lymphoid follicles.

These new histological criteria were compared with established diagnostic

criteria for the labial biopsy in 35 consecutive patients suspected for pSS

who underwent simultaneous biopsies from both sites. In addition, both

biopsies were compared for morbidity. RESULTS: The first analysis revealed a

focus score of >/=1 or lymphocytic infiltrates (not fulfilling the criterion

of a focus score of 1) combined with benign lymphoepithelial lesions as

diagnostic criteria for pSS. When comparing the parotid biopsy with the

labial biopsy sensitivity and specificity were comparable (sensitivity 78%,

specificity 86%). Level of pain was comparable and no loss of motor function

was observed. No permanent sensory loss was observed after parotid biopsy,

while labial biopsy led to permanent sensory loss in 6% of the patients.

Malignant lymphoma was detected in one parotid biopsy by chance, without

involvement of the labial salivary gland.

CONCLUSION: A parotid biopsy has a diagnostic potential comparable with that

of a labial biopsy in the diagnosis of pSS, and may be associated with less

morbidity.

PMID: 16891656

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

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