Out of 134, 12
sarcoidosis patients with symptoms of mucosal dryness as the first clinical manifestation were identified and compared with 30 consecutive unselected Sjögren's syndrome (SS) patients. Sicca manifestations were similar among the two groups, while parotid gland enlargement (
PGE) was more frequently found in
sarcoidosis patients (P < 0.05). Patients with
sarcoidosis had mainly pulmonary (P < 0.001) and skin involvement (P < 0.05), while SS patients presented more frequently with Raynaud's phenomenon (P < 0.05).
Autoantibody profile was more often found in SS patients compared to
sarcoidosis (P < 0.0025). The histopathological findings of minor salivary gland biopsy (
MSGB) revealed noncaseating
granulomas (NCG) in 58% of patients with
sarcoidosis, while in SS,
MSGB showed focal
sialadenitis in the majority of the patients. Transbronchial lung biopsy (TBLB), which was performed in 10
sarcoidosis patients, revealed the presence of NCG in all patients. In patients with
sarcoidosis and sicca symptoms as the presenting syndrome,
PGE is a useful clinical finding. Searching for pulmonary involvement is a determining factor to differentiate
sarcoidosis from SS. The absence of
autoantibodies is another useful tool for the diagnosis of
sarcoidosis. Finally,
MSGB is very helpful to discriminate between
sarcoidosis and SS and when
MSGB is not specific, then TBLB is valuable to confirm the diagnosis.