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Rheumatology Advance Access originally published online on November 24, 2006
Rheumatology 2007 46(2):370-371; doi:10.1093/rheumatology/kel364
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Comment on: Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

J. A. Friedman and E. B. Miller

Kaplan Medical Center, Rehovot, Affiliated to the Hebrew University School of Medicine, Jerusalem, Israel

Correspondence to: J. A. Friedman, E-mail: joshua_f{at}clalit.org.il

SIR, We read with interest the report of Pijpe et al. [1] comparing parotid gland with labial biopsy in 35 patients with Sjogren's syndrome. The authors report a diagnostic sensitivity of 78% with these methods, and a 6% incidence of permanent sensory loss with labial biopsy. In contrast to these findings, we published our experience with an office-based method of labial gland biopsy in which over 100 biopsies were performed, diagnostic sensitivity was 100%, and long-term sensory loss was 0% [2]. Our current experience is with over 350 patients in which only one individual has suffered from permanent sensory loss.

We suggest that the decision as to which biopsy be performed be based on all available techniques, and not be limited to the question of which gland (labial vs parotid) to biopsy.

The authors have declared no conflicts of interest.


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  1. Pijpe J, Kalk WWI, van der Wal JE, et al. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome. Rheumatology Advance Access: 2006.[Free Full Text]
  2. Friedman JA, Miller EB, Huszar M. (2002) A simple technique for minor salivary gland biopsy appropriate for use by rheumatologists in the outpatient setting. Clin Rheum 21:349–50.[CrossRef][Web of Science][Medline]
Accepted 21 September 2006


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R. Caporali, E. Bonacci, O. Epis, P. Morbini, and C. Montecucco
Comment on: parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's Syndrome
Rheumatology, October 1, 2007; 46(10): 1625 - 1625.
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