The role of a labial salivary gland biopsy in the diagnostic procedure for Sjögren's syndrome: a study of 94 cases
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Stein-Callenfels, Dewi van; Tan, Jonathan; Bloemena, Elisabeth; Vugt, Richard M. van; Voskuyl, Alexandre E.; Santana, Nathalie T.Y.; Van der Waal, Isaäc
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Aquest document és un/a article, creat/da en: 2014
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Objectives: The purpose of the present study is to examine the role of the outcome of the labial salivary gland
biopsy (LSGB) in the diagnostic procedure of patients suspected of suffering from Sjögren's syndrome (SS).
Material
and Methods: In a retrospective study the result of histopathological assessment of 94 consecutively taken
labial salivary gland biopsies has been examined. For the diagnosis of SS the American-European Consensus
Group classification (AECG, 2002) have been used. The outcome of the assessment has been discussed in relation
to a recently reported classification provided by the American College of Rheumatology (ACR, 2012).
Results: In the 94 LSGBs support for a diagnosis of SS has been encountered in 24 out of 26 patients with SS. In
the 68 patients with a negative diagnosis of SS only six positive LSGBs were observed. The sensitivity of the labial
biopsy amounted 0.92; the specificity was 0.91, while the positive predictive value and the negative predictive
value amounted 0.80 and 0.97 respectively. LSGBs taken by or on the request of the departments of Rheumatology
or Internal Medicine had a significant higher yield compared to LSGBs taken in other clinical departments.
Conclusion
s
: The LSGB may play a role in the diagnostic procedure of Sjögren's syndrome when using either the
AECG classification or the ACR classification. A LSGB should preferably taken after counseling for the possible
presence of SS by a department of Rheumatology or Internal Medicine since the yield of such biopsies is much
higher than in patients who have not been counseled by these departments prior to the taking of a LSGB.
When using the ACR classification, a positive serologic result and a positive ocular test make the taking of a LSGB
redundant. Only in case of a negative serologic outcome or a negative result of the ocular test a LSGB is indicated.
Since both the serologic test and the ocular test carry hardly any morbidity, these tests should, indeed, be performed
first before considering to take a LSGB.
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