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

Background: Salivary gland scintigraphy allows a non invasive, morphological and functional assessment of parotid and submaxillary salivary glands. Aim: To describe the main features of salivary gland scintigraphy in patients with Sjogren syndrome, rheumatic fibromyalgia and normal controls and compare the results with lip biopsy. Patients and methods: Sixty one normal controls, 66 patients with Sjogren syndrome and 18 patients with rheumatic fibromyalgia were studied. For the diagnosis of Sjogren syndrome and criteria were used, respectively. Lip biopsies were obtained in 52 patients with Sjogren 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, with mild or severe alterations. Results: Scintigraphy was normal in 74% of control subjects and in 26%, it had mild alterations. In 72% of patients with rheumatic fibromyalgia, scintigraphy was normal whereas in 28%, it had mild alterations. In 27% of patients with Sjogren syndrome, scintigraphy was normal, in 27% it had mild alterations and in 46%, severe alterations. There was a positive and significant correlation between pathological alterations of salivary glands and scintigraphic alterations (r=0.642, p < 0.001). Conclusions: Severe scintigraphic alterations of salivary gland strongly support the diagnosis of Sjogren syndrome. Mild alterations are non specific and a normal scintigraphy does not exclude the diagnosis.