<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2413-4341</journal-id>
<journal-title><![CDATA[Revista Paraguaya de Reumatología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. parag. reumatol.]]></abbrev-journal-title>
<issn>2413-4341</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Reumatología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2413-43412025000200042</article-id>
<article-id pub-id-type="doi">10.18004/rpr/2025.11.02.42</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Valor diagnóstico de la biopsia de glándulas salivales menores en pacientes con sospecha de enfermedad de Sjögren seronegativos]]></article-title>
<article-title xml:lang="en"><![CDATA[Diagnostic value of minor salivary gland biopsy in patients suspected of seronegative Sjögren's syndrome]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vázquez]]></surname>
<given-names><![CDATA[Marcos A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción, Facultad de Ciencias Médicas Hospital de Clínicas, Departamento de Reumatología]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>11</volume>
<numero>2</numero>
<fpage>42</fpage>
<lpage>46</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2413-43412025000200042&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2413-43412025000200042&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2413-43412025000200042&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La Enfermedad de Sjögren es una enfermedad autoinmune, caracterizada por la infiltración linfocitaria crónica de las glándulas exócrinas y diversas manifestaciones sistémicas extraglandulares. Si bien la mayoría de los pacientes son seropositivos (con anticuerpos Anti-Ro/SSA y Anti-La/SSB), existe un subgrupo significativo seronegativo que carece de estos marcadores, en donde la biopsia de glándula salival menor se convierte en una herramienta diagnóstica esencial.  Objetivos:  Evaluar la utilidad de la biopsia de glándula salival menor (BGSM) en el diagnóstico de enfermedad de Sjögren, en pacientes con alta sospecha clínica, pero con autoanticuerpos negativos, y caracterizar sus manifestaciones clínicas, el perfil serológico completo y el nivel de actividad de la enfermedad a través del score de ESSDAI (EULAR Sjögren&#8217;s Syndrome Disease Activity Index).  Materiales y métodos:  Se realizó un estudio observacional analítico, retrospectivo, de corte transversal que incluyó pacientes mayores de 18 años con sospecha de Enfermedad de Sjögren y autoanticuerpos negativos, con biopsia de BGSM, entre enero de 2023 y enero de 2025. La recolección de datos se basó en historias clínicas electrónicas y registros de anatomía patológica y un perfil serológico (ANA, Anti-Ro/SSA, Anti-La/SSB). El objetivo central fue evaluar la utilidad de la BGSM (mediante el focus score) y caracterizar la actividad de la enfermedad utilizando el score ESSDAI.  Resultados:  Se incluyeron siete pacientes de sexo femenino, con una edad media de 44.71 años (DE±13.21). Clínicamente, el 100% refirió xeroftalmía y el 71.4% xerostomía, aunque las pruebas funcionales objetivas (Test de Schirmer) fueron negativas en todos los casos. La BGSM fue positiva (focus score &#8805;1) en 6 de 7 pacientes (85.7%) con una media de focus score de 2.14 DE±1.574). A pesar de la remisión inicial, el análisis serológico reclasificó a 4 pacientes (57.1%) como seropositivos (Anti-Ro/SSA y/o Anti-La/SSB positivos), dejando a 3 pacientes (42.9%) como seronegativos verdaderos. La actividad global de la enfermedad, medida por el ESSDAI, fue de 7.14 DE±7.081), siendo el dominio glandular el más prevalente y con mayor carga de actividad (media 2.29).  Conclusión:  La Biopsia de Glándula Salival Menor es una herramienta diagnóstica de gran valor en el grupo de pacientes seronegativos. La actividad de la enfermedad, medida por ESSDAI, se concentró predominantemente en el dominio glandular.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Sjögren's disease is a common autoimmune disorder characterized by chronic lymphocytic infiltration of exocrine glands and various extraglandular systemic manifestations. While most patients are seropositive (with anti-Ro/SSA and anti-La/SSB antibodies), there is a significant seronegative subgroup that lacks these markers. In this group, minor salivary gland biopsy becomes an essential diagnostic tool.  Objectives:  To evaluate the usefulness of minor salivary gland biopsy (MSBG) in the diagnosis of Sjögren's disease in patients with a high clinical suspicion but negative autoantibodies, and to characterize its clinical manifestations, complete serological profile, and disease activity level using the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI).  Materials and methods: A retrospective, cross-sectional, analytical, observational study was conducted, including patients over 18 years of age with suspected Sjögren's disease and negative autoantibodies referred for minor salivary gland biopsy (MSBG) between January 2023 and January 2025. Data collection was based on electronic medical records, pathology reports, and serological profiles (ANA, Anti-Ro/SSA, Anti-La/SSB). The main objective was to evaluate the usefulness of minor salivary gland biopsy (MSGB) (using the focus score ) and to characterize disease activity using the ESSDAI score. Statistical analysis of the data was performed using IBM SPSS software version 30.0.0.  Results: Seven female patients were included, with a mean age of 44.71 years (SD ± 13.21). Clinically, 100% reported xerophthalmia and 71.4% xerostomia, although objective functional tests (Schirmer test) were negative in all cases. Minor salivary gland biopsy (MSGB) was positive (focus score &#8805; 1) in 6 of 7 patients (85.7%), with a mean focus score of 2.14 (SD ± 1.574). Despite the initial remission, serological analysis reclassified 4 patients (57.1%) as seropositive (anti-Ro/SSA and/or anti-La/SSB positive), leaving 3 patients (42.9%) as true seronegatives. The overall disease activity, as measured by the ESSDAI, was 7.14 (SD ± 7.081), with the glandular domain being the most prevalent and exhibiting the highest activity burden (mean 2.29).  Conclusion:  Minor salivary gland biopsy is a valuable diagnostic tool in the seronegative patient group. Disease activity, as measured by the ESSDAI, was predominantly concentrated in the glandular domain.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Enfermedad de Sjögren]]></kwd>
<kwd lng="es"><![CDATA[biopsia salival]]></kwd>
<kwd lng="es"><![CDATA[ESSDAI]]></kwd>
<kwd lng="en"><![CDATA[Sjögren's disease]]></kwd>
<kwd lng="en"><![CDATA[salivary biopsy]]></kwd>
<kwd lng="en"><![CDATA[ESSDAI.]]></kwd>
</kwd-group>
</article-meta>
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