Περίληψη:
Objective. Primary Sjögren syndrome (pSS), an autoimmune epithelitis, bears the risk of evolving to non-Hodgkin lymphoma and most frequently to the mucosa-associated lymphoid tissue (MALT) subtype. Based on the observation that pSS patients with MALT present a more atrophic and more intensely fissured tongue, we aimed to semiquantify severity of tongue atrophy and clinically assess lingual appearance in pSS patients with and without MALT, and investigate whether tongue atrophy and fissured appearance could serve as clinical indicators/signs of MALT. Methods. A blinded complete oral examination was performed in pSS patients with and without MALT. Tongue atrophy was scored using a semiquantified atrophy score. Clinical and laboratory variables were recorded for all patients. Results.After excluding pSS patients with oral candidiasis, iron deficiency, and megaloblastic anemia, 19 pSS patients with salivary MALT were matched 1:3 for age, sex, and disease duration with 57 pSS patients without MALT. The pSS-MALT patients had increased prevalence of salivary gland enlargement, lymphadenopathy, monoclonal gammopathy, rheumatoid factor positivity, higher focus and Tarpley scores in the minor salivary gland biopsy, and hyposalivation, compared to the pSS non-MALT patients. A significantly higher prevalence of tongue atrophy (68% vs 30%, p = 0.006) and fissured tongue (89% vs 33%, p < 0.001) was observed in the former group. Multivariate analysis showed that fissured tongue appearance, hyposalivation, and lymphadenopathy associate independently with salivary MALT in pSS. Conclusion. These results suggest that pSS patients with lymphoid malignancy exhibit a more atrophic and more fissured tongue. This particular clinical tongue appearance can serve as an additional clinical sign for salivary MALT lymphoma in pSS patients. © 2018. All rights reserved.
Συγγραφείς:
Zampeli, E.
Kalogirou, E.-M.
Piperi, E.
Mavragani, C.P.
Moutsopoulos, H.M.
Λέξεις-κλειδιά:
rheumatoid factor, adult; Article; case control study; clinical article; clinical assessment; cohort analysis; controlled study; disease duration; disease severity; epithelium cell; female; human; human cell; human tissue; hyposalivation; iron deficiency; laboratory test; lymphadenopathy; male; marginal zone lymphoma; megaloblastic anemia; middle aged; monoclonal immunoglobulinemia; mouth examination; prevalence; priority journal; salivary gland; salivary gland biopsy; salivary gland disease; salivary gland enlargement; scoring system; semiquantified atrophy score; Sjoegren syndrome; thrush; tongue atrophy; tongue disease; aged; atrophy; complication; epithelium cell; marginal zone lymphoma; pathology; salivary gland; salivary gland tumor; Sjoegren syndrome; tongue; tongue disease, Adult; Aged; Atrophy; Case-Control Studies; Epithelial Cells; Female; Humans; Lymphoma, B-Cell, Marginal Zone; Middle Aged; Salivary Gland Neoplasms; Salivary Glands; Sjogren's Syndrome; Tongue; Tongue Diseases
