Correlation of Tarplay’s grading system and diagnosis of patients suspected of having Sjögren’s syndrome, achieved at the Centro Médico Nacional «La Raza», México («La Raza» National Medical Center, Mexico)

Erika Jazmín Vallejo Bravo, Leandro Miguel Peña Torres, Porfirio Felipe Hernández Bautista


Aim: To establish any existing correlation between Tarplay’s grading system and patients with positive diagnosis of Sjögren’s syndrome. Methods: 321 cases of patients suspected to be affl icted with Sjögren’s syndrome were reviewed at the Highly Specialized Medical Units (UMAE), Centro Médico Nacional «La Raza» («La Raza» National Medical Center). These patients had been referred to the said center between January 2001 and December 2005. Patients had been referred as part of their study protocol. Patients were subjected to labial salivary gland biopsy. The procedure was undertaken under local anesthesia and using the technique described by Daniels. Evaluation was achieved using light microscopy and patients were graded according to Tarplay’s grading system. Sjögren’s syndrome diagnosis was established based on criteria proposed in 2002 by the Group of American and European Consensus. The main objective criterion used was histopathology of labial salivary glands. Results: Direct association was found between Tarplay’s index increase of labial salivary gland biopsies and Sjögren’s syndrome positive diagnosis. Fisher exact test was used with p < 0.001. OR = 0.13, with 95% confi dence interval (CI) and 0.004-0.045 rank. No association was found between the degree of fi brosis and positive diagnosis of Sjögren’s syndrome. Presence of rheumatoid arthritis and systemic lupus erythematosus was directly associated with secondary positive Sjögren’s syndrome (p < 0.001, OR = 3.25 with CI 95% = 1.8-5.6 and p = 0.004, OR = 4.0 with CI 95% = 1.4-10.9 respectively). Conclusions: Histological evaluation of labial salivary glands using Tarplay’s grading system is a reliable test to establish diagnosis of Sjögren’s syndrome.

Palabras clave

Sjögren’s syndrome, salivary glands, Tarplay

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