PMID- 19429722
OWN - NLM
STAT- MEDLINE
DCOM- 20091117
LR  - 20211020
IS  - 1931-3543 (Electronic)
IS  - 0012-3692 (Print)
IS  - 0012-3692 (Linking)
VI  - 136
IP  - 4
DP  - 2009 Oct
TI  - Minor salivary gland biopsy to detect primary Sjogren syndrome in patients with 
      interstitial lung disease.
PG  - 1072-1078
LID - S0012-3692(09)60606-1 [pii]
LID - 10.1378/chest.08-2839 [doi]
AB  - PURPOSES: To describe a cohort of patients who presented with interstitial lung 
      disease (ILD) of unknown cause, features of primary Sjogren syndrome (pSS), and a 
      positive minor salivary gland biopsy (MSGB). METHODS: Thirty-eight patients with 
      ILD evaluated at our center underwent an MSGB to confirm a diagnosis of pSS. All 
      of the samples were reviewed by pathologists experienced in the evaluation of 
      salivary gland histology. We defined a positive MSGB finding as a lymphocyte 
      focus score of >1. RESULTS: At presentation, all patients had ILD, and symptoms 
      of cough and dyspnea. None had a definable connective tissue disease (CTD) or 
      known cause for their ILD. Thirteen patients (34%) had positive MSGB findings. Of 
      these, the median age was 61 years (age range, 33 to 75 years); 7 patients (54%) 
      were women; 8 patients (62%) had a smoking history; and 10 patients (77%) had 
      sicca symptoms. In all patients, a thoracic high-resolution CT scan evaluation 
      demonstrated bibasilar, peripheral-predominant, ground-glass, and reticular 
      opacities. Four patients (31%) were negative for both antinuclear autoantibody 
      (ANA) and rheumatoid factor (RF) autoantibody, and three patients (23%) were 
      negative for ANA, RF, Sjogren syndrome (SS)-A, and SS-B autoantibodies. No 
      patients experienced any complications from the MSGB. The identification of 
      underlying pSS did not affect the management of ILD in these patients. 
      CONCLUSIONS: Confirming a diagnosis of pSS-related ILD by performing MSGB allows 
      for a more precise CTD classification. This study provides evidence that CTD may 
      exist subclinically, and longitudinal studies are needed to determine whether 
      identifying occult CTD impacts on management, longitudinal changes in lung 
      function, or survival.
FAU - Fischer, Aryeh
AU  - Fischer A
AD  - Autoimmune Lung Disease Center, National Jewish Medical and Research Center, 
      Denver, CO; Department of Rheumatology, National Jewish Medical and Research 
      Center, Denver, CO. Electronic address: fischera@njhealth.org.
FAU - Swigris, Jeffrey J
AU  - Swigris JJ
AD  - Autoimmune Lung Disease Center, National Jewish Medical and Research Center, 
      Denver, CO.
FAU - du Bois, Roland M
AU  - du Bois RM
AD  - Autoimmune Lung Disease Center, National Jewish Medical and Research Center, 
      Denver, CO.
FAU - Groshong, Steve D
AU  - Groshong SD
AD  - Department of Pathology, National Jewish Medical and Research Center, Denver, CO.
FAU - Cool, Carlyne D
AU  - Cool CD
AD  - Department of Pathology, National Jewish Medical and Research Center, Denver, CO.
FAU - Sahin, Hakan
AU  - Sahin H
AD  - Department of Radiology, National Jewish Medical and Research Center, Denver, CO.
FAU - Lynch, David A
AU  - Lynch DA
AD  - Department of Radiology, National Jewish Medical and Research Center, Denver, CO.
FAU - Gillis, JoAnn Z
AU  - Gillis JZ
AD  - Department of Rheumatology, National Jewish Medical and Research Center, Denver, 
      CO.
FAU - Cohen, Marc D
AU  - Cohen MD
AD  - Department of Rheumatology, National Jewish Medical and Research Center, Denver, 
      CO.
FAU - Meehan, Richard T
AU  - Meehan RT
AD  - Department of Rheumatology, National Jewish Medical and Research Center, Denver, 
      CO.
FAU - Brown, Kevin K
AU  - Brown KK
AD  - Autoimmune Lung Disease Center, National Jewish Medical and Research Center, 
      Denver, CO.
LA  - eng
GR  - K23 HL092227/HL/NHLBI NIH HHS/United States
PT  - Journal Article
DEP - 20090508
PL  - United States
TA  - Chest
JT  - Chest
JID - 0231335
RN  - 0 (Autoantibodies)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Autoantibodies/analysis
MH  - Biopsy
MH  - Female
MH  - Humans
MH  - Lung Diseases, Interstitial/*complications/diagnostic imaging/etiology
MH  - Lymphocytes/pathology
MH  - Male
MH  - Middle Aged
MH  - Salivary Glands, Minor/*pathology
MH  - Sjogren's Syndrome/*pathology
MH  - Tomography, X-Ray Computed
PMC - PMC3662204
EDAT- 2009/05/12 09:00
MHDA- 2009/11/18 06:00
PMCR- 2010/10/01
CRDT- 2009/05/12 09:00
PHST- 2009/05/12 09:00 [entrez]
PHST- 2009/05/12 09:00 [pubmed]
PHST- 2009/11/18 06:00 [medline]
PHST- 2010/10/01 00:00 [pmc-release]
AID - S0012-3692(09)60606-1 [pii]
AID - 082839 [pii]
AID - 10.1378/chest.08-2839 [doi]
PST - ppublish
SO  - Chest. 2009 Oct;136(4):1072-1078. doi: 10.1378/chest.08-2839. Epub 2009 May 8.