Sjögren and non-Sjögren sicca disease: clinicopathological and ultrasonographic findings in a Brazilian cross-sectional study

OBJECTIVE: Oral manifestations and salivary gland involvement in individuals with non-Sjögren sicca (non-SjD) or Sjögren disease (SjD) remain poorly characterized. We assessed the clinical, histopathological, and ultrasonographic features of individuals with non-SjD and compared them with those of patients diagnosed with SjD. STUDY DESIGN: A cross-sectional comparative study was conducted at two Brazilian referral centers. Patients underwent clinical assessment, measurement of unstimulated salivary flow, evaluation of oral dryness, serological testing, minor salivary gland biopsy, and major salivary gland ultrasonography based on OMERACT scoring criteria. SjD classification was determined according to the 2016 ACR/EULAR criteria. Data were analyzed descriptively and analytically. RESULTS: Among the 176 patients included (122 with SjD and 54 with non-SjD), salivary hypofunction (77.5%; P = .002), presence of germinal centers (13.8%; P = .017), and moderate-to-severe inflammation in minor salivary gland biopsies (83.7%; P < .001) were significantly more frequent in the SjD group. OMERACT gray-scale ultrasound scores were also higher in the SjD group. In non-SjD patients, age was associated with nonspecific histological changes, including acinar atrophy, duct dilation, fibrosis, and adipose tissue infiltration. CONCLUSION: Non-SjD and SjD differed primarily in inflammatory severity and ultrasound findings. Age-related glandular degeneration was more pronounced in non-SjD, indicating potentially distinct clinicopathological profiles.