Abstract
<h3>Background</h3> Xerostomia resulting from medications or systemic disorders may differ in histopathologic findings. <h3>Objective</h3> To compare clinical and pathological features from patients with xerostomia and minor salivary gland biopsies and search for features suggesting IgG-related disease. <h3>Materials and Methods</h3> Retrospective analysis of consecutive biopsies between 2009 and 2017. Histomorphometry included glandular architecture, fibrosis, fat replacement, inflammation density, plasma cells, and IgG/IgG4 in selected cases. <h3>Results</h3> The study included 64 cases, 18 male and 46 female patients, with a mean age of 56. Biopsy was taken for suspected Sjögren syndrome (SS) in 58 cases (91%). Fifty-four biopsies had adequate specimen for SS evaluation; only 12 met microscopic criteria supporting SS (22.2%). Polypharmacy (>3 drugs) was found to be inversely related to SS (<i>P</i> = .05). The majority of the entire study group had various systemic conditions (63%), most often hyperlipidemia and high blood pressure (28% each). The use of medications was recorded in 66%, 50% of which used 2 or more. Fat replacement, fibrosis, and acinar atrophy showed significant correlations with increased age (<i>P</i> < .05). Fat replacement correlated with hyperlipidemia and polypharmacy. Stains for IgG/IgG4, performed in 4 cases in which fibrosis and plasma cells were observed, were all negative. <h3>Conclusions</h3> SS was confirmed in only 22% of cases. Increased age correlated with acinar atrophy, fat replacement, and fibrosis, explaining xerostomia in older patients without SS. Hyperlipidemia showed associated fat replacement. Polypharmacy was significantly more common in non-SS cases. Attention to the patient's medical history and medications used may lead to correct diagnosis, reducing the need for lip biopsy in the majority of cases.
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