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Value of labial salivary gland histopathology for diagnosis of Sjögren's syndrome in patients with anti‐centromere antibody positivity
Author(s) -
Tsukamoto Masako,
Suzuki Katsuya,
Tsunoda Kazuyuki,
Ikeura Kazuhiro,
Kameyama Kaori,
Takeuchi Tsutomu
Publication year - 2020
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13895
Subject(s) - medicine , histopathology , biopsy , salivary gland , rheumatism , dry mouth , rheumatology , pathology , gastroenterology , dermatology , saliva
Aim/Introduction Although anti‐centromere antibody (ACA)+ Sjögren's syndrome (SS) is considered a subtype of SS, it was not included in the recent American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) SS classification criteria. ACA+ patients without anti‐SS‐A/Ro antibodies require salivary gland histopathology to fulfill the ACR/EULAR criteria for diagnosis of SS. We reviewed salivary gland histology among ACA+ patients referred for the diagnosis of SS using the ACR/EULAR and Japanese criteria which does not require biopsy. Method Data from 147 ACA+ patients with dry eyes and/or mouth who visited our department were retrospectively analyzed. Clinical, immunological, and histological data were collected and statistically analyzed. Result Sixty‐five patients (44%) had undergone labial salivary gland biopsy. The frequency of dry mouth was higher in ACA+ patients who had undergone labial salivary gland biopsy than in those who had not ( P = .046), while there were no differences in biopsy rates between patients with and without sclerodactyly ( P = .51). According to the current ACR/EULAR classification criteria, Greenspan grade of 3 or 4 for labial salivary gland histopathology is required in patients without anti‐SS‐A/Ro antibody for the diagnosis of SS. Four patients with Greenspan grades <3 and anti‐SS‐A/Ro antibody met the criteria for SS. In 54 patients in which the ACR/EULAR criteria were met, 53 patients were diagnosed with SS using the Japanese criteria. Conclusion In ACA+/anti‐SS‐A/Ro– antibody patients, agreement between ACR/EULAR and Japanese criteria sets was excellent. For easily classifying ACA+ patients as SS cases, salivary gland biopsy should be performed in ACA+ patients with dry symptoms to identify ACA+ patients.