Sarcoidosis: oral and perioral manifestations.

A 46-year-old white woman with lesions on the lower lip, perioral area and in the soft tissues of the oral cavity (gingivae and palate) was examined. The clinical signs were recorded, and incisional biopsies from the oral lesions were taken. The diagnosis of sarcoidosis was established by the histopathological evidence of typical non-caseating granulomas from tissue biopsy, supported by serum ACE- 57.9 U/L, blood calcium 16.83 mEq/L and 24-hrs urine calcium 600 mg). Oral lesions may be the first or the only sign of sarcoidosis in an otherwise healthy patient.

Salivary alterations in insulin-dependent diabetes mellitus.

OBJECTIVES: To examine the flow rate and composition of unstimulated whole saliva and of serum in children with newly diagnosed insulin-dependent diabetes mellitus (IDDM) and to compare these with values for a group of healthy controls. DESIGN: Cross-sectional. SETTING: Diabetic Department of a University Hospital in Thessaloniki, Greece. SUBJECTS AND METHODS: The test group was made up of 10 recently diagnosed child patients with IDDM, aged 4-15 years and free of other systemic disease. Ten healthy children aged 5-17 years served as controls. Children were clinically examined before unstimulated saliva was collected over a 5 minute period and blood samples taken. Saliva and serum measurements included glucose, total proteins, albumin and immunoglobulins (IgA, IgG). RESULTS: No significant difference was seen in salivary flow rate between the two groups. Significantly greater concentrations of glucose were seen in saliva and serum in children with IDDM. Neither total protein nor albumin differed significantly between the two groups. Salivary IgA concentration was higher in the test group as was serum IgG. CONCLUSIONS: Findings in this sample suggest that changes in salivary composition may, together with estimated glucose levels, play a helpful diagnostic role in the early stages of IDDM in some children.

Glutamic acid decarboxylase autoantibodies in saliva of children with type 1 diabetes.

The aim of this study was to investigate the presence of glutamic acid decarboxylase (GAD) autoantibodies in the saliva of children with type 1 diabetes. A total of 30 diabetic children were used in this study while 80 healthy individuals of similar age were used as controls. Total saliva and peripheral blood was collected from all diabetic children and controls. Determination of GAD autoantibodies was performed using an enzyme immunoassay (Varelisa) which is based on a recombinant human GAD65. The results of this study showed that GAD autoantibodies were found to be present in 21 out of 30 diabetic serum samples, while they were present in all samples of diabetic saliva. In contrast, they were absent from serum and saliva of healthy controls. Since GAD is considered one of the basic antigenic targets of the autoimmune process in type 1 diabetes in the pancreatic beta cells, its presence in the saliva may be relevant as a predictive marker.