Stratification for Salivary Gland Biopsy in the Diagnosis of Sjögren’s Disease
8399
Mayson B. Mustafa
Mayson B. Mustafa, Hannah Cottom , Zahra Syed, Michele Bombardieri, Nurhan Sutcliffe and Anwar R Tappuni.
Background
Patients with Sjögren’s disease (SD) are frequently encountered in oral medicine clinic. Minor salivary gland biopsy (MSGB) is the gold standard diagnostic procedure; however, it can be associated with morbidity. Salivary glands ultrasonography (SGUS) has emerged as a promising tool for the diagnosis of SD. The aim of this study was to explore whether results of clinical tests and the SGUS can identify patients who would benefit from having a biopsy to reach a diagnosis.
Methods
An observational, retrospective study was undertaken including all patients who had MSGB at the Sjogren’s MDT clinic at RLH over 16 months period. Data was extracted from records and documented electronically. Provisional diagnosis of SD was made employing the ACR/EULAR criteria and the results of the SGUS, and then compared with the biopsy results. Statistical summary tests and chi squared test were used for analysis.
Results
48 patients were included with a mean age of 48.63 ±15.5 years. 91.7% were females. In 24 patients, a provisional diagnosis confirming or excluding the diagnosis of SD was reached before MSGB was undertaken. The biopsy results did not change the diagnosis in 21/24 (88%) of cases. The provisional diagnosis in the other 24 patients was equivocal due to inconsistency between the blood tests and the SGUS results. In 20 (83%) of these cases the MSGB results enabled the confirmation or the exclusion of SD. Interestingly, high agreement (91%) between the findings of the SGUS and the MSGB was found (p<0.001).
Conclusion
Previous studies investigated predictors for the results of MSGB. Similarly, this study provided evidence that patients can be stratified for MSGB based on the results of clinical, laboratory and imaging investigations. This will effectively reduce the number of patients undergoing the biopsy procedure, improving clinical efficiency and patients’ experience.
References
1- doi.org/10.5114/reum/163213
2- doi.org/10.1111/jop.12387
