Minor Salivary Gland Biopsy for the Diagnosis of Neurosarcoidosis.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

European Neurology Pub Date : 2023-01-01 DOI:10.1159/000529920

Nicolas Fournier, Yvan Jamilloux, Mathieu Gerfaud-Valentin, Nathalie Streichenberger, Sandra Vukusic, Romain Marignier, Géraldine Androdias, Pascal Seve

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引用次数: 0

Abstract

Introduction: The definite diagnosis of neurosarcoidosis is challenging since it requires a compatible histology of the nervous system. When neurosarcoidosis is suspected, other systemic manifestations are investigated to confirm the diagnosis. A minor salivary gland biopsy (MSGB) is often performed since it is minimally invasive. The objective of the present study was to assess its performance for the diagnosis of neurosarcoidosis.

Methods: A retrospective single-center study included patients who underwent a MSGB in a tertiary neurological university hospital (Lyon, France) between 2015 and 2018. Clinical presentations unlikely to be compatible with neurosarcoidosis were excluded. Positive cases of neurosarcoidosis were defined as definite, probable, and possible cases, according to the latest international neurosarcoidosis diagnostic criteria from the Neurosarcoidosis Consortium Consensus Group.

Results: A total of 529 patients underwent a MSGB for clinical manifestations compatible with neurosarcoidosis. Among the 13 who fulfilled the criteria for neurosarcoidosis, only one had a positive MSGB. The sensitivity of MSGB was 7.7% (95% CI [0.2-36.0%]) and the specificity was 100.0% (95% CI [99.3-100%]).

Conclusion: Considering the low sensitivity of MSGB for the diagnosis of NS, MSGB should be performed in selected indications, including a suspicion of spinal cord sarcoidosis, or when there is a strong clinical, laboratory, and radiological suspicion of NS. MSGB should rather not be performed when the chest CT-scan does not show signs of pulmonary or lymph node sarcoidosis.

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小唾液腺活检诊断神经结节病。

神经结节病的明确诊断是具有挑战性的，因为它需要神经系统相容的组织学。当怀疑神经结节病时，应检查其他全身表现以确认诊断。小涎腺活检(MSGB)通常进行，因为它是微创的。本研究的目的是评估其诊断神经结节病的表现。方法:一项回顾性单中心研究纳入了2015年至2018年在法国里昂某三级神经大学医院接受MSGB手术的患者。排除不太可能与神经结节病相容的临床表现。根据神经结节病联盟共识组最新的国际神经结节病诊断标准，将神经结节病阳性病例定义为明确、可能和可能病例。结果:共有529例患者接受了符合神经结节病临床表现的MSGB检查。在13例符合神经结节病诊断标准的患者中，只有1例MSGB阳性。MSGB的敏感性为7.7% (95% CI[0.2 ~ 36.0%])，特异性为100.0% (95% CI[99.3 ~ 100%])。结论:考虑到MSGB对NS诊断的敏感性较低，应选择适应症进行MSGB检查，包括怀疑脊髓结节病，或临床、实验室和放射学怀疑NS较强的适应症。当胸部ct扫描未显示肺结节病或淋巴结结节病时，不应进行MSGB检查。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Neurology 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

审稿时长

4-8 weeks

期刊介绍： ''European Neurology'' publishes original papers, reviews and letters to the editor. Papers presented in this journal cover clinical aspects of diseases of the nervous system and muscles, as well as their neuropathological, biochemical, and electrophysiological basis. New diagnostic probes, pharmacological and surgical treatments are evaluated from clinical evidence and basic investigative studies. The journal also features original works and reviews on the history of neurology.