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Vol. 11. Issue 3.
Pages 156-160 (May - June 2015)
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Vol. 11. Issue 3.
Pages 156-160 (May - June 2015)
Original Article
DOI: 10.1016/j.reumae.2014.06.007
Usefulness of Antibodies and Minor Salivary Gland Biopsy in the Study of Sicca Syndrome in Daily Clinical Practice
Utilidad de los anticuerpos y de la biopsia de glándula salival menor en el estudio del complejo sicca en la práctica diaria
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Maria Lida Santiagoa,
Corresponding author
lidasantiagor@yahoo.com.ar

Corresponding author.
, Maria Renata Seisdedosa, Rodrigo Nicolás Garcia Salinasa, Antonio Catalán Pelleta, Liliana Villalónb, Anastasia Seccoa
a Servicio de Reumatología, Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
b Cátedra de Anatomía Patológica, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
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Tables (3)
Table 1. Demographic and Clinical Characteristics.
Table 2. Results of the univariate analysis: demographic and clinical characteristics between MSGB+ and MSGB−.
Table 3. S, Sp, PPV, NPV, and PLR of the Different Antibodies in Relation to the MSGB (Gold Standard).
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Abstract
Objectives

To assess the association between histologic findings in the minor salivary gland biopsy (MSGB) and anti La (La/SS-B) and antiRo antibodies (Ro/SS-A), antinuclear antibodies (ANA) and rheumatoid factor (RF), and compare the value of the latter as diagnostic tests with MSGB, considered as the gold standard.

Materials and methods

Patients with suspected primary Sjögren syndrome (PSS) referred for MSGB were included. Antibody measurements were performed. Grades III and IV biopsy results were considered positive.

Results

Two hundred and eighteen (218) patients were included, 95% females, with a median age of 54 years and 12 months median duration of sicca symptoms. Thirty-six of the biopsies were positive. 33% of patients had positive anti Ro/SS-A anti La/SS-B antibodies, 62% had positive ANA, and 31% positive RF. A statistically significant association was found between MSGB and anti Ro/SS-A anti La/SS-B, ANA and RF. ANA were the most sensitive antibodies (84%. 95% CI: 75– 92), and the most specific were: anti Ro/SS-A and/or anti La/SS-B (78%. 95% CI: 71–85) and RF (78%. 95% CI: 69–87).

Conclusion

On PSS clinical suspicion, anti Ro/SS-A and anti La/SS-B antibodies have a great value to achieve the diagnosis, with MSGB useful for diagnosis of seronegative patients. The results also suggest the importance of ANA and RF for PSS classification.

Keywords:
Sicca complex
Sjögren
Salivary gland biopsy
Anti Ro/SS-A
Anti La/SS-B
Resumen
Objetivos

Evaluar la asociación entre los hallazgos histológicos de la biopsia de glándula salival menor (BGSM) y los anticuerpos anti La (La/SS-B), anti Ro (Ro/SS-A), anticuerpos antinucleares (FAN) y factor reumatoideo (FR), y comparar el valor de estos como test diagnóstico con la BGSM considerada como patrón oro.

Material y métodos

Se incluyeron pacientes con sospecha de síndrome de Sjögren primario (SSp) derivados para realización de BGSM. Se realizó medición de anticuerpos y se consideró BGSM positiva a los grados III y IV de la clasificación de Chisholm.

Resultados

Se incluyeron 218 pacientes, 95% género femenino, con una mediana de edad de 54 años y de tiempo de evolución de los síntomas sicca de 12 meses. El 36% de las biopsias fueron positivas. El 33% de los pacientes presentaban anticuerpos anti Ro/SS-A anti La/SS-B positivos, 62% FAN positivo y el 31% FR positivo. Se encontró asociación estadísticamente significativa entre la BGSM y anti Ro/SS-A, anti La/SS-B, FAN y FR. El FAN resultó ser el anticuerpo más sensible (84% IC95%: 75-92), siendo los más específicos: anti Ro/SS-A y/o anti La/SS-B (78% IC95%: 71-85) y el FR (78% IC95%: 69-87).

Conclusión

Ante la sospecha clínica de SSp, los anticuerpos anti Ro/SS-A y anti La/SS-B son de gran valor para arribar al diagnóstico, siendo la BGSM especialmente útil en los pacientes seronegativos. Los resultados también sugieren la utilidad del FAN y el FR para la clasificación de SSp.

Palabras clave:
Complejo sicca
Sjögren
Biopsia de glándula salival
Anti Ro/SS-A
Anti La/SS-B

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