Correlations between the histopathological alterations in minor salivary glands and the clinically suspected Sjogren's syndrome

In sicca syndrome patients the xerostomia, xerophthalmia and the serological findings may strongly suggest the autoimmune Sjogren's syndrome, but the histological findings in the labial salivary gland biopsies do not always justify the suspected diagnosis. The aim of this study was to compare the histomorphological changes and the clinical findings in patients with pathologically established Sjogren's syndrome and in cases with negative histology. A total of 133 labial biopsies have been retrospectively evaluated from 2015 to May 2022, and the characteristic Sjogren's lesions were found in 67 cases. According to the clinical data, 34 cases proved to be primary, and 33 were associated (secondary) forms. In 66 cases, the histology did not justify Sjogren's syndrome; a significant acinar loss, fibrolipomatous infiltration, and mild sialadenitis had led to the clinical symptoms. In Sjogren's histologies, the acinar loss was detected in just 31.8% of cases, which might indicate that the diminished saliva production represents immune-mediated hypofunction rather than direct damage of the acini. This is the first systemic study in Hungary investigating the correlation between pathological alterations and clinical findings.

Automated summary

This study compared the histomorphological changes and clinical findings in patients with pathologically confirmed Sjogren's syndrome and those with negative histology. It found that only 31.8% of Sjogren's histologies showed acinar loss, suggesting that decreased saliva production may be due to immune-mediated hypofunction rather than direct acinar damage. This is the first systemic study in Hungary to investigate the correlation between pathological alterations and clinical findings.