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[Is bioptic assurance reasonable in patients with Sjögren's syndrome? From focus score to diagnosing vasculitides].

Authors
  • Krenn, V1
  • Jakobs, M
  • Kriegsmann, J
  • Krukemeyer, M G
  • Rieger, A
  • 1 Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Max-Planck-Str. 18+20, 54296 Trier. [email protected]
Type
Published Article
Journal
Zeitschrift fur Rheumatologie
Publication Date
February 2010
Volume
69
Issue
1
Pages
11–18
Identifiers
DOI: 10.1007/s00393-009-0514-7
PMID: 19997922
Source
Medline
License
Unknown

Abstract

Sjögren's syndrome is an autoimmune disease which targets the salivary and lacrimal glands in particular, causing sicca syndrome. Extraglandular manifestations are often seen. Chronic sialadenitis of the parotid gland is the most common symptom to be assessed for differential diagnosis. Common HE and Giemsa slices are histopathologically examined and graduated for lymphocyte infiltration (focus): grade 0: absent, grade 1: slight, grade 2: moderate non-focal infiltration, grade 3: 1 focus (> or =50 lymphocytes) per 4 mm2, grade 4: >1 focus. Grade 3 infiltrates correspond to a focus score of 1, which is one of four disease-classifying criteria acknowledged for diagnosis. Bioptic examination is also performed to rule out different (non-) immunologic sialadenitises, such as the necrotizing or epithelioid-like form (in sarcoidosis), and the extranodal marginal-zone lymphoma. Extraglandular manifestations of Sjögren's syndrome can also be safely diagnosed by histopathological examination. Emphases lie on vasculitides and myositides. Bioptic work-up, therefore, is not only reasonable but also an essential tool for diagnostics in Sjögren's syndrome.

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