ab1904

Focal sialadenitis in patients with early synovitis

M.T. Brennan¹, S.R. Pillemer², R. Goldbach-Mansky³, H. El-Gabalawy³ H. Schumacher, Jr.^4,5, P.C. Fox⁶

¹Clinical Research Core (CRC) and ²Gene Therapy and Therapeutics Branch (GTTB), National Institute of Dental and Craniofacial Research (NIDCR); the ³National Institute of Arthritis and Musculoskeletal Diseases, National Institutes of Health (NIH), Bethesda, MD; ⁴Rheumatology Division, University of Pennsylvania and ⁵VAMC, Philadelphia, PA; and ⁶Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA.

ABSTRACT
Objective
To investigate the frequency of sialadenitis on lip biopsy in patients with synovitis of recent onset (ES), and see how sialadenitis relates to clinical and laboratory findings of ES.

Methods
Joint involvement, laboratory measures and biopsies of the minor salivary glands were evaluated in 10 ES patients. Diagnosis at a one-year follow-up exam was noted.

Results
Six ES patients (60%) had a positive lip biopsy (mononuclear cell focus score greater than 1). ES patients with a positive lip biopsy presented with oligoarthritis, while ES patients with a negative lip biopsy had a more polyarticular presentation. No differences in laboratory measures between patients with a positive and negative lip biopsy were present. Seven ES patients had a diagnosis of rheumatoid arthritis and three had undifferentiated arthritis at the end of one year.

Conclusion
ES patients had a higher than expected frequency of focal sialadenitis.

Key words
Early synovitis, focal sialadenitis, salivary glands, rheumatoid arthritis, Sjögren's syndrome.

Please address correspondence and reprint requests to: Dr. Michael T. Brennan, Carolinas Medical Center, Department of Oral Medicine, 1000 Blythe Blvd., MEB-409, Charlotte, NC 28232-2861, USA.
E-mail: mbrennan@carolinashealthcare.org