Background/Purpose:
Sjögren’s syndrome (SS) is an inflammatory autoimmune disease characterized by lymphoid infiltration of exocrine glands, although extraglandular involvement is frequently observed. Prevalence is around 0.5% to 1%. There have always been difficulties for the classification and diagnosis of patients. Several criteria have been proposed. The classification criteria used in recent years where those established by the American-European Consensus Group in 2002. Recently, new classification criteria have been published by the International Collaborative Clinical Alliance Cohort; these criteria have been approved by the American College of Rheumatology. Although minor salivary gland biopsy has been used throughout the years, its findings are not highly specific.
Objectives: Primary. To determine the agreement between a positive minor salivary gland biopsy and having al least 4 of the 6, 2002 criteria, as well as having 2 of the 3, 2012 criteria. Secondary: To determine the agreement between 2002 and 2012 SS classification criteria.
Methods:
This is a retrospective study consisting of clinical chart review from patients with primary SS (PSS) and secondary SS (SSS), having minor salivary gland biopsy report. Clinical chart review included patients attending the Rheumatology Clinic at the National Institute of Cardiology in Mexico City, between January 1, 2000, and May 31, 2011. Clinical manifestations, serology, and the biopsy report were obtained in all patients. Biopsies were considered positive when a focal lymphocytic sialadenitis with a focus score ≥ 1 focus (> 50 cells)/4 mm2 was observed. Biopsies were assessed by the same expert pathologist. The 2002 and 2012 criteria were applied according to their requirements. Descriptive statistic was used and kappa index was calculated as an agreement measure. A p value < 0.05 was considered significant. SPSS version 15.0 was used for the statistical analysis.
Results:
A total of 75 clinical charts with a biopsy report were reviewed; 8 patients were excluded because information was incomplete. 67 patients were included in the analysis, 62 women and 5 men. 55.2% had PSS and 44.8% had SSS. The agreement between a positive biopsy and having 4 of the 6, 2002 criteria, was weak (kappa = 0.27; p = 0.01); the agreement of a positive biopsy with having 2 of the 3, 2012 criteria, was moderate (kappa = 0.5; p < 0.0001). The agreement between the 2002 criteria and the 2012 criteria was good (kappa = 0.70; p < 0.0001), when all the patients were considered. In the SSS patients, the agreement decreased (kappa = 0.44; p = 0.003).
Conclusion:
The agreement between a positive biopsy and having 4 of the 2002 criteria was low, and moderate when having 2 of the 20012 criteria. The agreement between the 2002 and the 2012 criteria was very good when PSS patients were included, however, it decreased when only the SSS patients were included.
Disclosure:
L. A. Martinez,
None;
C. Flores,
None;
A. Arana Fraustro,
None;
L. H. Silveira,
None.
ACR Meeting Abstracts - https://acrabstracts.org/abstract/overall-agreement-between-sjogrenss-minor-salivary-gland-biopsy-and-2002-and-2012-classification-criteria/