Background/Purpose: To determine whether the repetition of minor salivary gland biopsy (MSGB) has a clinical diagnostic utility in patients with suspicion of primary Sjögren’s syndrome (pSS).

Methods: We studied retrospectively patients with suspected pSS who had routinely benefited from two MSGB at our institution between January 1, 1990 and January 14, 2015. We collected for each of these patients the clinical and biological features and the results of the two MSGB, as well as the diagnoses performed by the evaluating physician after each biopsy. We compared the characteristics of patients with and without a clinical diagnosis of pSS after the first MSGB, and analysed the changes between the two MSGB.

Results: We included 93 patients, 18 pSS and 75 npSS (clinical diagnosis after the first MSGB). pSS patients were significantly older and more often had renal or pulmonary involvement, and, as expected, had more often rheumatoid factor, anti-SSA and anti-SSB antibodies and positive biopsy with focus score ≥ 1 or Chisholm score > 2. The mean time between the 2 MSGB was 5.7+/-4.3 years. The concordance between the results of the 2 biopsies was low (k=0.345). Diagnosis changed after the second MSGB in 23 cases, but in only 13 patients the second biopsy was considered clinically useful to revise the initial diagnosis.

Conclusion: There was a low concordance between two MSGB in patients with suspected pSS in our study. Despite this variability, performing a second MSGB changed the initial diagnosis in a minority of the patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-utility-of-a-second-minor-salivary-gland-biopsy-in-patients-with-suspected-sjogrens-syndrome-a-retrospective-cohort-study/