To the Editor.
—Diagnosis of Sjögren's syndrome (SS) is based on clinical examination of the eyes and mouth, and biopsy of the minor salivary glands. The principal histologic changes in the minor salivary glands are lymphocytic infiltration. Although it was naturally supposed that keratoconjunctivitis sicca is due to the desiccation resulting from lack of tears, Pflugfelder et al1 presented the hypothesis that the conjunctiva is also directly affected in SS.We report herein the lymphocytic infiltration of the conjunctiva in patients with SS by brush cytologic study of the conjunctiva.2 Patients with SS (two men and 38 women with a mean age of 53.1±7.4 years), patients with keratoconjunctivitis sicca without any systemic abnormalities (11 women with a mean age of 55.3±3.2 years), and normal subjects (one man and nine women with a mean age of 50.1±8.5 years) were recruited for this study.Using the cytobrush with the
Hikichi T, Yoshida A, Tsubota K. Lymphocytic Infiltration of the Conjunctiva and the Salivary Gland in Sjögren's Syndrome. Arch Ophthalmol. 1993;111(1):21–22. doi:10.1001/archopht.1993.01090010023009
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