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Assessment of labial salivary gland changes in patients with rheumatoid arthritis by subjective and quantitative methods.

Biopsy of the minor salivary glands is an accepted method in the diagnosis of Sjögren's syndrome, the most characteristic feature being the prominent inflammatory cell infiltration. However, difficulties exist in the early diagnosis of Sjögren's syndrome. The present study was conducted to analyse by subjective and quantitative methods the morphological changes of the salivary glands in patients with rheumatoid arthritis (RA) frequently complicated by Sjögren's syndrome. The subjects of this study were 71 RA patients (mean age 54 +/- 15 years) and their 45 healthy age-matched controls (mean age 60 +/- 14 years). The histologic parameters evaluated were: inflammatory cell infiltration; acinar atrophy; fibrosis, and fatty infiltration. Statistically significant differences between the RA and the control groups were found in all parameters (p less than 0.001) except the fatty infiltration. This indicates that destruction of the salivary glands including fibrosis and acinar atrophy is associated with RA. Only the fatty infiltration seems to be an age-dependent change. All salivary gland biopsies of the RA patients were photographed and evaluated planimetrically, for the same parameters as in the subjective evaluation. An excellent reproducibility between the two methods was found, thus indicating the applicability of the subjective evaluation in the assessment of early salivary gland changes in RA patients.