Background: In Japan, common biopsy sites for diagnosing sarcoidosis are the lung, skin, or lymph nodes. However, in Western countries, minor salivary gland biopsy is often selected because it is more easily accessible and has low morbidity. We report a case of sarcoidosis diagnosed by minor salivary gland biopsy.
Case presentation: A 54-year-old woman experienced bilateral myodesopsia and photophobia. Three months thereafter, she visited an ophthalmologist and was diagnosed with bilateral uveitis. She was then referred to another ophthalmologist; however, definite diagnosis of sarcoidosis was difficult to conclude; thus, she was referred to our department. At the initial examination, her corrected visual acuity was 1.2 OD and 1.0 OS. We observed vitreous opacity and retinal exudates bilaterally. In the right eye, the retinal exudates were raised similar to choroidal tumors, indicating tumor characteristics. Fluorescein angiography revealed that retinal exudates and perivascular nodules exhibited hyperfluorescence. However, we were unable to diagnose sarcoidosis using other tests, such as blood tests, chest computed tomography (CT), bronchoscopy, and whole-body contrast-enhanced CT. She underwent minor oral salivary gland biopsy because she was positive for anti-SS antibody, and Sjögren syndrome was considered. The results showed that she had sarcoidosis and Sjögren syndrome. Following administration of sub-Tenon injection of triamcinolone acetonide, the ocular lesions subsided.
Conclusions: We encountered a patient with complicated sarcoidosis and Sjögren syndrome that was diagnosed using minor salivary gland biopsy. Minor salivary gland biopsy may be useful for diagnosing sarcoidosis in Japan.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 344-351, 2020