Salivary gland scintigraphy and lip biopsy in patients with Sjogren syndrome and normal controls

Background: Salivary gland scintigraphy allows a non invasive, morphologica l and functional assessment of parotid and submaxillary salivary glands. Ai m: To describe the main features of salivary gland scintigraphy in patients with Sjogren syndrome, rheumatic fibromyalgia and normal controls and comp are the results with lip biopsy. Patients and methods: Sixty one normal con trols, 66 patients with Sjogren syndrome and 18 patients with rheumatic fib romyalgia were studied. For the diagnosis of Sjogren syndrome and criteria were used, respectively. Lip biopsies were obtained in 52 patients with Sjo gren syndrome. Scintigraphy was done with a gamma camera and computer after the administration of 99mTc-pertechnetate, obtaining images during 30 min and creating time/activity curves. Scintigraphy was classified as normal, w ith mild or severe alterations. Results: Scintigraphy was normal in 74% of control subjects and in 26%, it had mild alterations. In 72% of patients wi th rheumatic fibromyalgia, scintigraphy was normal whereas in 28%, it had m ild alterations. In 27% of patients with Sjogren syndrome, scintigraphy was normal, in 27% it had mild alterations and in 46%, severe alterations. The re was a positive and significant correlation between pathological alterati ons of salivary glands and scintigraphic alterations (r=0.642, p < 0.001). Conclusions: Severe scintigraphic alterations of salivary gland strongly su pport the diagnosis of Sjogren syndrome. Mild alterations are non specific and a normal scintigraphy does not exclude the diagnosis.