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Safety and procedural success of minor salivary gland biopsy in Sjögren’s disease: a retrospective analysis of 202 patients

1, 2, 3, 4, 5, 6, 7

 

  1. Division of Rheumatology and Immunology, Medical University of Graz, Austria.
  2. Division of Rheumatology and Immunology, Medical University of Graz, Austria.
  3. Division of Rheumatology and Immunology, Medical University of Graz, Austria.
  4. Division of Rheumatology and Immunology, Medical University of Graz, Austria.
  5. Division of Rheumatology and Immunology, Medical University of Graz, Austria; and Department of Rheumatology, Hospital of Brunico (SABES-ASDAA), Brunico, Italy.
  6. Division of Rheumatology and Immunology, Medical University of Graz, Austria.
  7. Division of Rheumatology and Immunology, Medical University of Graz, Austria. martin.stradner@medunigraz.at

CER19764
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PMID: 42544612 [PubMed]

Received: 04/02/2026
Accepted : 19/05/2026
In Press: 15/07/2026

Abstract

OBJECTIVES:
Minor salivary gland biopsy (MSGB) is a standard procedure in the diagnosis of Sjögren’s disease (SjD). Biopsy techniques using a vertical or horizontal mucosal incision are applied in daily practice; the former may be safer due to underlying neuroanatomy. Here we aim to quantify and classify adverse events (AEs) of MSGB using vertical incision technique.
METHODS:
Medical records of patients with suspected SjD who underwent MSGB at our outpatient clinic between January 2014 and April 2024 and had follow-up visits were analysed. The MSBG consisted of a 1 cm linear vertical incision in the oral mucosa of the lower lip to collect up to five lip salivary glands. All biopsies were performed by rheumatologists in a non-surgical setting.
RESULTS:
202 of 257 patients undergoing MSGB met inclusion criteria. Median follow-up time was 16.5 (IQR: 1-51.8) months. Four biopsies (2%) did not yield sufficient material for histological analysis. One serious adverse event (0.5%), local persistent paraesthesia, and two moderate adverse events (1.0%), including one case of prolonged bleeding and one unclassified event, were reported. Mild AEs occurred in 18 patients (8.9%). Local discomfort after biopsy affected 32 patients (15.8%). AEs subsided either during or up to 2 hours after biopsy in 14 patients (6.9%) and in 38 patients (18.8%) within three weeks, respectively.
CONCLUSIONS:
MSGB with vertical incision technique has a very low frequency of serious and long-term complications with a success rate of 98%.

DOI: https://doi.org/10.55563/clinexprheumatol/13prjb

Rheumatology Article