medigraphic.com

1999, Number 3

<< Back Next >>

Rev Med Hosp Gen Mex 1999; 62 (3)

Histopathologic findings of the lacrimal gland in patients with idiopathic chronic uveitis

Tenorio G, Ruiz–Morales ML, Martínez-Castro F, Cruz H

Language: Spanish
References: 18
Page: 158-164
PDF size: 188.74 Kb.


ABSTRACT

Purpose: To determine if histological changes are shown in the lacrimal gland which support the etiologic diagnosis of chronic uveitis. Methods: it is a clinico-pathological study, observational, prospective and transversal, done at the General Hospital of Mexico. Complete ophthalmological examinations were done to a group of 16 patients suffering chronic uveitis idiopathic type and a control group of 14 patients without uveitis. Laboratory tests were done to put aside infectious diseases, autoimmune and infiltrative disorders of the orbit. The biopsy of the lacrimal gland was done under local anesthesia and the histopathologic study under microscopy of lighting. Results: No modifications were found in the control group; the studied group included 14 patients, 13 women and one man with average age of 44.9 years old and an interval from 25 to 66. Lymphocytic infiltration was seen type II (mild, light) in two patients with anterior no granulomatous uveitis, in a 36 years old man with high levels of IgG and a 47 years old woman with ECA lightly high and positive Schirmer’s test: showing nodular infiltration without germinal centers formed by mature lymphocytes and plasmocytoids having widening of the stroma and acinar infiltration. One of the slides showed necrosis with the consequent focal detriment of the gland. In a 31 years old woman with lightly IgG increases and positive Schirmer’s test there were changes suitable with cystadenoma. Conclusions: Most of the lacrimal glands in patients with uveitis (85.8%) didn’t have histological changes and were very similar to those of control group, so that, it is our thought that the biopsy of the lacrimal gland should only be done when specific disease is suspected affecting the gland as in sarcoidosis or in Sjögren syndrome.


REFERENCES

  1. Guy G M, Holds JB and Kincaid MC. Sarcoidosis involving the lacrimal gland. JAMA 1993; 270 (4): 508

  2. St.Clair EW. New developments in Sjögren’s syndrome. Curr Opin Rheumatol 1993; 5: 604-612.

  3. Bloch-Michel E, Nussenblatt RB: International uveitis study group recommendations for the evaluation of intraocular inflammatory disease. Am J Ophthalmol 1987; 103: 234-235

  4. Chisholms DM, Mason DK. Labial salivatory gland biopsy in Sjögren’s syndrome. J Clin Pathol 1969; 21: 656-660.

  5. Hiroto Obata, Seiichiro Yamamoto, Hajime Horiuchi and Rikuo Machinami. Histopathologic study of human lacrimal gland. Ophthalmology 1995; 102 (4): 678-86.

  6. Kaplan HJ, Waldrep C, Nicholson JKA and Gordon D. Immunologic analysis of intraocular mononuclear cell infiltration in uveitis. Arch Ophthalmol 1984; 102: 57-65.

  7. Deschénes J, Freeman WR, Char DH and Garovoy MR. Lymphocyte subpopulations in uveitis. Arch Ophthalmol 1986; 104: 233-240.

  8. Stevens G, Chi-Chao Chan, Wetzig Rp, Nussenblatt RB and Palestine AG. Iris lymphocytic infiltration in patients with quiescent uveitis. Am J Ophthalmol 1987; 104: 508-15.

  9. Waterhouse JP. Focal adenitis in salivatory and lacrimal glands. Proc R Soc Med 1963; 56: 911-918.

  10. Nasu M, Matsubara O and Yamamoto H. Post-mortem prevalence of lymphocytic infiltration of the lacrymal gland: A comparative study in autoimmune and non-autoimmune diseases. J Pathol 1984; 143: 11-15.

  11. Franklin RM, Kenyon KR and Tomas TB. Immunohistologic studies of human lacrimal gland: Localization of immunoglobulins. Secretory component and lactoferrin. J Immunol 1973; 110: 984-92.

  12. Roen JL, Stasior OG, Jakobiec FA. Aging changes in the human lacrimal gland: Role of the ducts. CLAO J 1985; 2: 237-242.

  13. Wieczorek R, Jakobiec FA, Sacks EH and Knowles DM. The immunoarchitecture of the normal human lacrimal gland. Ophthalmol 1988; 95: 100-109.

  14. Chandler JW, Gilete TE. Immunologic defense mechanisms of the ocular surface. Ophthalmology 1983; 90: 585-591.

  15. Chandler JW. Immunology of the ocular surface. Int Ophthalmol Clin 1985; 25: 13-23.

  16. Spaide RF, Ward DL. Conjunctival biopsy in the diagnosis of sarcoidosis. Br J Ophthalmol 1990; 74: 469-471

  17. Hershey JM, Pulido JS, Folderg R, Folk JC and Massicotte SJ. Non-caeating conjunctival granulomas in patients with multifocal choroiditis and panuveitis. Ophthalmology 1994; 101 (3): 596-601.

  18. Rosenbaum JT and Bennett RM. Chronic anterior and posterior uveitis and primary Sjögren’s syndrome. Am J Ophthalmol 1987; 104: 346-352.




2020     |     www.medigraphic.com