TY - JOUR T1 - With Minor Salivary Gland Biopsy in Sjögren Syndrome, Is a Negative Result Possible? JF - The Journal of Rheumatology JO - J Rheumatol SP - 310 LP - 312 DO - 10.3899/jrheum.190743 VL - 47 IS - 3 AU - DIANA M. MONSALVE AU - JUAN-MANUEL ANAYA Y1 - 2020/03/01 UR - http://www.jrheum.org/content/47/3/310.abstract N2 - In this issue of The Journal, Sharma, et al1 report on the differences among 3 groups of patients with Sjögren syndrome (SS). The first had a focus score (FS) of < 1 in the minor salivary gland (MSG) biopsy, another had an FS ≥ 1, and the other had an FS of zero. Patients without focal lymphocytic infiltration (i.e., FS = 0) exhibited a low frequency of anti-La antibodies, corneal compromise, and hypergammaglobulinemia, and had no elevated expression of interferon-regulated genes, but did have systemic disease. However, all these patients showed positive anti-Ro antibodies. These results indicate that anti-Ro antibodies may be a key factor influencing the development of the disease, and that the MSG biopsy may be negative in patients with SS.SS is a chronic autoimmune disease characterized by a progressive lymphocytic and plasma cell infiltration that mainly affects the salivary and lachrymal glands and leads to xerostomia and keratoconjunctivitis sicca (sicca symptoms). The diagnosis of SS is based on the combination of symptoms (sicca symptoms) and the presence of autoimmune characteristics: activation of B cells (i.e., presence of auto-antibodies) and/or T cells (i.e., positive MSG biopsy)2. The classification of the disease is currently based on the American-European consensus group classification criteria [American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR)], which include serological tests, clinical findings, and histological examination3. The presence of autoantibodies or a positive MSG biopsy is mandatory3.MSG biopsy plays an essential role in the diagnosis, stratification, and prognosis of SS as well as in the differential diagnosis of the disease (i.e., sarcoidosis, amyloidosis, etc.)4,5. In our view, for diagnostic purposes the MSG biopsy is preferred to parotid and lacrimal gland biopsies because it is less invasive and safer while offering similar … Address correspondence to Dr. J.M. Anaya, CREA, School of Medicine and Health Sciences, Universidad del Rosario, Carrera 24 No. 63C-69, Bogotá, Colombia. E-mail: juan.anaya{at}urosario.edu.co ER -