Evaluation Of Minor Salivary Glands For Amyloidosis And Sjögren's Syndrome

Objective: The purpose of this study was to examine minor salivary gland biopsies of SS patients for amyloid deposits.

Methods: Fifty biopsies diagnosed as chronic sclerosing sialadenitis from patients with xerostomia were examined. Formalin-fixed paraffin embedded salivary gland specimens were cut into 5µ sections. The sections were examined for amyloid deposits using Congo Red staining and immunohistochemistry (IHC). IHC was performed using a mouse monoclonal antibody to serum amyloid A with a polymer-based detection complex and appropriate positive and negative controls. Congo Red stained sections were evaluated using polarizing light microscopy.

Results: Of the 50 specimens examined, 35 were from patients with SS; 29 had primary SS and 6 had secondary SS. The remaining 15 specimens were from patients who had salivary gland dysfunction but did not meet the American-European criteria for the diagnosis of SS. Forty three specimens were from females and 7 from males; mean age was 67.7+ 9.52 years (median 66.5 yrs). The mean stimulated salivary output was 0.26 + 0.20 SD (median 0.21) ml/ min/ gland. Ten of the biopsies were from patients with non-measurable salivary output, < 0.0 ml/min/ gland. Initial evaluation of the biopsies, based on the Sjögren's grading system, indicated that 21-biopsies were grade (3 or 4); 27-grade (1 or 2); and 2 were grade (0). Despite the presence of fibrosis, none of the biopsy specimens showed evidence of amyloid deposits either by Congo Red or by IHC.

Conclusion: These findings do not support an overlap between Sjögren's syndrome and amyloidosis. Further, our results suggest that fibrosis seen in sclerosing sialadenitis is not necessarily associated with amyloid deposits.