Minor salivary gland immunohistology in the diagnosis of primary Sjögren's syndrome

J Oral Pathol Med. 2009 Mar;38(3):282-8. doi: 10.1111/j.1600-0714.2008.00697.x. Epub 2008 Sep 12.


Background: Focal lymphocytic infiltrates of minor salivary glands are considered target-organ related signs of Sjögren's syndrome. The percentages of plasma cells expressing IgA, IgG and IgM in minor salivary gland biopsies have also been suggested as useful in establishing a diagnosis of Sjögren's syndrome, and this study aimed at evaluating this method.

Methods: All biopsies from patients under investigation for Sjögren's syndrome (n = 210) at our department during 4 years were analyzed for IgA, IgG and IgM producing cells by immunohistochemistry, and related to Sjögren classification parameters.

Results: A focus score >or=1 was observed in 67/210 patients and the frequency of IgA producing cells was <70% in 42/210 patients. Sufficient clinical data for classification of disease were available for 57/210 patients. Patients were classified as having primary Sjögren's syndrome (pSS) (n = 9), secondary Sjögren's syndrome (sSS) (n = 12) or non-Sjögren's syndrome (non-SS) (n = 36). IgA expressing cells were significantly decreased (P < 0.01) and IgG expressing cells significantly increased (P < 0.02) in patients with pSS compared to non-SS. Also, increased numbers of salivary gland IgG producing plasma cells correlated with increased IgG serum levels (P < 0.001). However, there was no significant difference between sSS and non-SS with regard to IgA, IgG or IgM expressing cells in the glands.

Conclusions: Our results support previous reports indicating the relevance of quantitative evaluation of Ig isotype expression in plasma cells in the clinical investigation of Sjögren's syndrome and further indicate a difference in plasma cell populations between pSS and sSS.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Cell Count
  • Female
  • Humans
  • Immunoglobulin A / biosynthesis
  • Immunoglobulin G / biosynthesis
  • Immunoglobulin M / biosynthesis
  • Immunohistochemistry
  • Immunophenotyping
  • Male
  • Middle Aged
  • Mouth Mucosa / immunology
  • Mouth Mucosa / pathology
  • Plasma Cells / metabolism
  • Salivary Glands, Minor / immunology*
  • Salivary Glands, Minor / pathology
  • Sjogren's Syndrome / classification
  • Sjogren's Syndrome / immunology*
  • Sjogren's Syndrome / pathology


  • Immunoglobulin A
  • Immunoglobulin G
  • Immunoglobulin M