Reversibility of histological and immunohistological abnormalities in sublabial salivary gland biopsy specimens following treatment with corticosteroids in Sjogren's syndrome

Sjogren's syndrome (SS) is a chronic autoimmune disease characterised by sp ecific lesions in exocrine glands, so sublabial minor salivary gland biopsy (SLGB) plays an important part in its diagnosis. The extent and compositio n of the lymphocytic infiltrate in SLGB specimens can be considered as targ et organ specific parameters. They are quantified after histological and im munohistological examination by a focus score (describing the extent of the infiltrate) and IgA% score (describing the composition of the infiltrate), respectively. However, little is known about the factors that contribute t o the extent and composition of the infiltrate and whether these features a re reversible as repeated SLGBs are rarely performed. A patient with SS is described who underwent SLGBs before and after treatment with high dose cor ticosteroids. After treatment there was not only clinical improvement, but also improvement in the histological and immunohistological parameters. Alt hough these findings need to be confirmed in further studies, this suggests that histopathological changes may be reversible in SS. Furthermore, it sh ows that the potential effects of corticosteroid use should be taken into a ccount when interpreting SLGB specimens. When clinical changes do parallel histological changes, repeated SLGBs might offer a marker for disease activ ity in patients with SS.