A importância dos achados clínicos e microscópicos orais no diagnóstico da síndrome de Sjögren

Abstract

The diagnosis of Sjogren’s syndrome depends on the interaction of several subjective and objective parameters, which are obtained by means of clinical and laboratory investigation. Apart from the subjective findings (xerostomia e xeroftalmia), blood tests and the objective evaluation of the salivary and lacrimal gland function are part of the diagnostic routine of thesyndrome. Biopsy of minor salivary glands from the lower lip has been used as an important diagnostic criteria for diagnosis of the syndrome, but the quality of the specimens and the subjective interpretation of the histological parameters by the pathologists can limit its usefulness. Focal lymphocytic infiltrate on the salivary glands has been considered an important histological marker for diagnosis. The aim of the present study is to report three cases diagnosed as Sjogren’s syndrome with the aid of the histological features observed in the affected salivary glands. The three patients were submitted to biopsy of minor salivary glands from the lower lip due to oral symptoms and clinical alterations leading to the suspicion of Sjogren’s syndrome. In all three specimens the presence of numerous focal lymphocytic infiltrates was the histological feature that lead to final diagnosis compatible with the syndrome. There were no complications associated with the surgical procedures and the postoperative period and tissue repairing were within normal limits. Biopsies of labial minor salivary glands are useful in diagnosing Sjogren’s syndrome and the early indication of this surgical procedure seems important to demonstrate the glandular lymphocytic infiltrate. The precise interpretation of the histological features turn them reproductible and adequate technical steps, correct specimen preservation and criterious histological analysis is essential for diagnosis of the Sjogren’s syndrome.