IMMUNOHISTOLOGIC STUDIES OF SKIN AND SUBLABIAL SALIVARY-GLANDS IN SJOGRENS-SYNDROME

Background: The authors describe their experiences with immunofluorescent examination of the skin and of the sublabial salivary glands in patients with the Sjogren's syndrome. Methods: Frozen slices of skin and sublabial salivary glands were incubated with antibodies against IgG, IgA, IgM, C3, C1q, C4 and fibrin/fibrinogen was marked with fluorescein isotiocianate. Results: Positive skin immunohistological findings were observed in 7 out of 21 patients (33%) with primary Sjogren syndrome. Five cases showed IgM deposits on the dermo-epidermal border, in 2 cases vascular deposits were found and in another 2 nuclear IgG staining. In 11 patients out of 42 with sicca symptoms (26%) IgA, IgG and IgM deposits were observed at the basal membrane of the glandular epithelium, while in one patient IgG positive nuclear immunofluorescence was found. Conclusions: IgM deposits on the dermo-epidermal border are not pathognomonic for patients with primary Sjogren's syndrome but they do have their own characteristics (generally they are fine granular and ribbon-like). Immunoglobulin deposits in the sublabial salivary glands in patients with primary Sjogren's syndrome is a concurrent phenomenon and of no diagnostic value.