Research Article Minimally Invasive Minor Salivary Gland Biopsy for the Diagnosis of Amyloidosis in a Rheumatology Clinic Ridvan Mercan, 1 Berivan BJtJk, 1 Mehmet Engin Tezcan, 2 Arif Kaya, 3 Abdurrahman Tufan, 1 Mehmet Akif Özturk, 1 Seminur Haznedaroglu, 1 and Berna Goker 1 1 Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ic Hastalıklari ABD, Romatoloji BD, Besevler, 06500 Ankara, Turkey 2 Department of Rheumatology, Kartal Research and Training Hospital, 34890 Istanbul, Turkey 3 Department of Rheumatology, State Hospital, 20125 Denizli, Turkey Correspondence should be addressed to Ridvan Mercan; mercanridvan@hotmail.com Received 19 December 2013; Accepted 15 January 2014; Published 23 February 2014 Academic Editors: S. Coaccioli and T. Miyazaki Copyright © 2014 Ridvan Mercan et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Systemic amyloidosis is a potentially fatal condition, unless diagnosed and treated before development of irreversible organ damage. Demonstration of amyloid deposits within tissue biopsies is only deinitive diagnostic method, which makes appropriate selection of biopsy site essential. Herein, we evaluated eicacy of minimally invasive minor salivary gland biopsy (MSGB) for the diagnosis of amyloidosis. Methods. We analyzed 37 biopsies taken from 35 patients. Suggestive indings for amyloidosis were signiicant proteinuria, renal impairment, refractory diarrhea, neuropathy, and restrictive cardiomyopathy. Minor salivary gland was the initial biopsy site in all subjects. When MSGB was negative but there was a high suspicion for amyloidosis, a kidney, duodenum, or rectal biopsy was performed for further investigation. Results. Mean age of patients was 45.4 and 21 were female. In 11 patients amyloidosis was diagnosed with MSGB. In overall 18 patients were diagnosed with amyloidosis. Sixteen of them were identiied as being of AA type and two were AL type amyloidosis. he sensitivity of minimally invasive MSGB is 61.1% for diagnosing amyloidosis in this study. Conclusion. MSGB is a safe and simple method for the diagnosis of amyloidosis which can be performed in an outpatient setting. We suggest extensive use of this minimally invasive method. 1. Introduction Amyloidosis is a potentially fatal condition characterized by extracellular deposition of nonbranching protein ibrils in organs [1]. his devastating condition is mainly caused by plasma cell disorders and numerous inlammatory diseases including autoimmune and chronic infectious diseases [2, 3]. Demonstration of amyloid deposits in biopsy specimens is the only way of establishing the diagnosis of amyloidosis [4, 5]. herefore, appropriate selection of biopsy site is essential. he sensitivity and speciicity of histopathology varies greatly according to where the tissue biopsy is obtained [5, 6]. Sensitivity of biopsy samples from visceral organs is higher; however, it requires more invasive procedures with bearing higher risk of complications, such as bleeding, hematoma, and perforation. Abdominal fat pad, gingiva, and rectum are the most common initial biopsy sites because of their ease of accessibility, low complication rate, and lower costs [5]. However, diagnostic yield of these biopsies is somewhat lower compared to visceral organ biopsies. Minor salivary glands have parenchymal and secretory components with considerable blood supply. herefore, labial salivary glands are a good biopsy site for the demonstration of amyloid deposits [7]. Minimally invasive minor salivary gland biopsy (MSGB) is an easy procedure which can be performed by nonsurgical physicians with lower risk com- plications [5]. Since rheumatic diseases are a common cause of secondary amyloidosis and abovementioned advantages increased use of MSGB in rheumatology departments [8]. However, there is inconsistency in the literature about its utility and diagnostic yield [7, 9–11]. Hence, we aimed to investigate eicacy of this procedure for the assessment of amyloidosis in our patient population. Hindawi Publishing Corporation ISRN Rheumatology Volume 2014, Article ID 354648, 3 pages http://dx.doi.org/10.1155/2014/354648