Associations between salivary gland histopathologic diagnoses and phenotypic features of Sjögren's syndrome among 1,726 registry participants

Troy E. Daniels, Darren Cox, Caroline H. Shiboski, Morten Schiodt, Ava Wu, Hector Lanfranchi, Hisanori Umehara, Yan Zhao, Stephen Challacombe, Mi Y. Lam, Yvonne De Souza, Julie Schiodt, Helena Holm, Patricia A. M. Bisio, Mariana S. Gandolfo, Toshioki Sawaki, Mengtao Li, Wen Zhang, Beni Varghese-Jacob, Per IbsenAlicia Keszler, Nozomu Kurose, Takayuki Nojima, Edward Odell, Lindsey A. Criswell, Richard Jordan, John S. Greenspan

Research output: Contribution to journalArticlepeer-review

252 Citations (Scopus)

Abstract

Objective. To examine associations between labial salivary gland (LSG) histopathology and other phenotypic features of Sjogren's syndrome (SS). Methods. The database of the Sjogren's International Collaborative Clinical Alliance (SICCA), a registry of patients with symptoms of possible SS as well as those with obvious disease, was used for the present study. LSG biopsy specimens from SICCA participants were subjected to protocol-directed histopathologic assessments. Among the 1,726 LSG specimens exhibiting any pattern of sialadenitis, we compared biopsy diagnoses against concurrent salivary, ocular, and serologic features. Results. LSG specimens included 61% with focal lymphocytic sialadenitis (FLS; 69% of which had focus scores of >= 1. per 4 mm(2)) and 37% with nonspecific or sclerosing chronic sialadenitis (NS/SCS). Focus scores of >= 1 were strongly associated with serum anti-SSA/SSB positivity, rheumatoid factor, and the ocular component of SS, but not with symptoms of dry mouth or dry eyes. Those with positive anti-SSA/SSB were 9 times (95% confidence interval [95% CI] 7.4-11.9) more likely to have a focus score of >= 1 than were those without anti-SSA/SSB, and those with an unstimulated whole salivary flow rate of = 1 than were those with a higher flow rate, after controlling for other phenotypic features of SS. Conclusion. Distinguishing FLS from NS/SCS is essential in assessing LSG biopsies, before determining focus score. A diagnosis of FLS with a focus score of >= 1 per 4 mm(2), as compared to FLS with a focus score of
Original languageEnglish
Pages (from-to)2021 - 2030
Number of pages10
JournalArthritis & Rheumatism
Volume63
Issue number7
DOIs
Publication statusPublished - Jul 2011

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