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International Journal of Rheumatology
Volume 2012, Article ID 303506, 6 pages
http://dx.doi.org/10.1155/2012/303506
Clinical Study

Is IgG4-Related Disease a Cause of Xerostomia? A Cohort Study of 60 Patients

1Department of Internal Medicine, Regional Competence Group on Adults' Auto immune and Rare systemic diseases, G. Montpied Hospital, University Hospital of Clermont-Ferrand, 63003 Clermont-Ferrand Cedex 1, France
2Department of Pathology, G. Montpied Hospital, University Hospital of Clermont-Ferrand, 63003 Clermont-Ferrand Cedex 1, France
3Department of Internal Medicine, Estaing Hospital, University Hospital of Clermont-Ferrand, 63003 Clermont-Ferrand Cedex 1, France
4Department of Pathology, Estaing Hospital, University Hospital of Clermont-Ferrand, 63003 Clermont-Ferrand Cedex 1, France
5Immunology Laboratory, Estaing Hospital, University Hospital of Clermont-Ferrand, 63003 Clermont-Ferrand Cedex 1, France
6Department of Rheumatology, G. Montpied Hospital, University Hospital of Clermont-Ferrand, 63003 Clermont-Ferrand Cedex 1, France

Received 22 June 2012; Revised 10 September 2012; Accepted 11 September 2012

Academic Editor: Ronald F. van Vollenhoven

Copyright © 2012 M. Hermet et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Immunoglobulin-G4-(IgG4-) related disease (IgG4 RD) is a fibrosing process characterized by a significant infiltration of IgG4-secreting plasma cells. IgG4 RD can affect almost all organs including salivary glands. Whether IgG4 RD plays a role in the development of sicca syndrome and particularly dry mouth syndrome remains to be investigated. Methods. We conducted a monocentric cohort study for two years to search for IgG4 RD features in patients with dry mouth syndrome using immunostainings of labial salivary gland specimens with anti-IgG4 antibody. Results. Among 60 patients presenting with dry mouth syndrome who underwent labial salivary gland biopsy, 18 showed positive immunostaining with the anti-IgG4 antibody including 4 patients with typical systemic IgG4 RD. Five also fulfilled criteria for Sjögren's syndrome. Conclusion. These findings suggest that clinical forms of IgG4 RD salivary involvement without salivary swelling may occur. This salivary involvement is probably overlooked in everyday practice and could represent a mild form of IgG4 RD.