RESEARCH - Safety and usefulness of minor salivary gland biopsy: retrospective analysis of 502 procedures performed at a single center

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Arthritis Rheum. 2008 May 15;59(5):714-20.

Safety and usefulness of minor salivary gland biopsy: retrospective

analysis of 502 procedures performed at a single center.

Caporali R, Bonacci E, Epis O, Bobbio-Pallavicini F, Morbini P, Montecucco C.

Department of Rheumatology, University of Pavia, IRCCS San Matteo

Foundation, Pavia, Italy.

OBJECTIVE: To analyze the safety of our biopsy technique and the

effectiveness of minor salivary gland biopsy (MSGB) for the diagnosis

of Sjögren's syndrome (SS) and amyloidosis. METHODS: We conducted a

retrospective analysis of 452 patients with suspected SS and 50 with

suspected amyloidosis and negative periumbilical fat aspiration

analysis who underwent MSGB at a single center. Diagnostic evaluation

for SS included Schirmer's test, unstimulated whole salivary flow,

detection of antinuclear antibodies and anti-SSA/SSB, erythrocyte

sedimentation rate, C-reactive protein, IgM rheumatoid factor, and

serology for hepatitis C virus. For all biopsy samples, a cumulative

focus score on multilevel sections was calculated. SS was diagnosed

according to American-European Consensus Group (AECG) criteria.

Histologic evaluation for amyloidosis was performed using Congo red

staining and polarized-light microscopy. Adverse events were recorded

on a questionnaire immediately after the procedure and 7 days, 14

days, and 6 months thereafter. RESULTS: Sixty-four patients (12.7%)

reported transient adverse events: 40 paresthesias lasting <7 days, 17

paresthesias lasting <14 days, 27 cases of local swelling, and 8

external hematoma. One patient has had local paresthesia for 2 years.

A total of 498 (99.2%) samples provided adequate material for

histologic analysis. Of 452 patients evaluated for SS, 378 were

finally evaluated. Ninety-three patients (24.5%) had a cumulative

focus score > or =1, and 87 (94.5%) of 93 satisfied the AECG criteria.

Classification of SS was possible for 124 (32.8%) of 378 patients. In

51 (41%) of 124, MSGB was essential to reach the number of criteria

needed for classification. Of 50 patients evaluated for amyloidosis,

10 (20%) had positive Congo red staining.

CONCLUSION: MSGB is a simple, safe, and reliable tool for the

diagnosis of SS and amyloidosis, and therefore is suitable for more

extensive application.

PMID: 18438907

http://www.ncbi.nlm.nih.gov/pubmed/18438907

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