Background:In the diagnosis of primary Sjogren’ syndrome (SS), salivary gland ultrasound is useful tool. Until now, there is no data for ultasonographic changes of major salivary glands over time.Objectives:This study aimed to evaluate the changes in abnormalities of salivary gland ultrasound (SGUS) over time in patients with pSS.Methods:Patients with pSS (n=70) and idiopathic sicca syndrome (n=18) underwent SGUS twice at baseline and 2 years later. The semi-quantitative SGUS score (0-48) was used, which comprises five parameters: parenchymal echogenicity, homogeneity, hypoechoic areas, hyperechogenic reflections, and clearness of posterior borders. The intraglandular power Doppler signal (PDS) was also assessed. The changes of these SGUS variables were compared in patients with pSS and idiopathic sicca syndrome.Results:The median (interquartile range) total SGUS scores at baseline was 27 (14) in patients with and 4 (3) in those with idiopathic sicca syndrome (p<0.001). In the pSS group, the total SGUS scores and the SGUS scores for bilateral parotid glands were significantly increased during median 23.4 month follow-up (p=0.013 andp=0.011, respectively). Homogeneity and hypoechoic areas were the domain to show statistically significant progression of SGUS scores. None of the SGUS scores changed significantly in the patients with idiopathic sicca syndrome. In patients with pSS, baseline and follow-up PDS sum scores of four salivary glands were significant higher in worsening SGUS group (n=13) than no change/improvement SGUS group (n=55/2).Conclusion:The structural abnormalities in major salivary glands assessed using SGUS scores progressed significantly in patients with pSS. In pSS group, 18.6% patients had worsening SGUS scores during 2 years. Intra-glandular hypervascularity was associated with worsening of salivary gland abnormalities.References:[1]Delli K, Dijkstra PU, Stel AJ, Bootsma H, Vissink A, Spijkervet FK. Diagnostic properties of ultrasound of major salivary glands in Sjogren’s syndrome: a meta-analysis. Oral diseases. 2015;21(6):792-800.[2]Jousse-Joulin S, Devauchelle-Pensec V, Cornec D, Marhadour T, Bressollette L, Gestin S, et al. Brief Report: Ultrasonographic Assessment of Salivary Gland Response to Rituximab in Primary Sjogren’s Syndrome. Arthritis & rheumatology (Hoboken, NJ). 2015;67(6):1623-8.[3]Gazeau P, Cornec D, Jousse-Joulin S, Guellec D, Saraux A, Devauchelle-Pensec V. Time-course of ultrasound abnormalities of major salivary glands in suspected Sjogren’s syndrome. Joint, bone, spine: revue du rhumatisme. 2018;85(2):227-32.[4]Lee KA, Lee SH, Kim HR. Diagnostic and predictive evaluation using salivary gland ultrasonography in primary Sjogren’s syndrome. Clinical and experimental rheumatology. 2018;36 Suppl 112(3):165-72.Acknowledgments: :This work was funded by the Konkuk University Medical Center Research Grant 2019.Disclosure of Interests:None declared
Background:While salivary gland ultrasound (SGUS) has widely used for evaluating Sjögren’s syndrome, information on SGUS findings of systemic sclerosis (SSc) is limited.Objectives:We aimed to evaluate the salivary gland involvement in patients with SSc using SGUS.Methods:We consecutively included patients with SSc fulfilling American College of Rheumatology/European League against Rheumatism (ACR/EULAR) 2013 classification criteria, primary Sjögren’s syndrome (pSS) fulfilling ACR/EULAR 2016 classification criteria, and idiopathic sicca syndrome. All patients underwent SGUS examination using the Outcome Measures in Rheumatology (OMERACT) definition of a SGUS scoring system. The hyperechoic bands using 0-3 scoring system (none/<25% of the parenchyma/25-50% />50%) and intraglandular power Doppler signal (PDS) were assessed. Hocevar scoring system (0-48) comprising parenchymal echogenicity, homogeneity, hypoechoic areas, hyperechogenic reflections, and clearness of posterior borders were also evaluated.Results:A total of 147 patients were included in the study: SSc (n=59), pSS (n=56), and idiopathic sicca syndrome (n=32). The proportion of the highest OMERACT grades among the four glands≥ 2 were significantly higher in SSc (54.2%) and pSS (62.5%) than idiopathic sicca syndrome (3.1%). Total OMERACT SGUS scores, total fibrosis scores, Hocevar score were significantly higher in SSc and pSS compared to idiopathic sicca syndrome (Table 1). The proportion of the highest fibrosis grades among the four glands ≥2 were significantly higher in SSc (79.7%) than pSS (62.5%) and idiopathic sicca syndrome (46.9%). There were no significant differences in PDS among 3 groups. Twenty-one patients (65.6%) of 32 SSc patients with OMERACT grade ≥2 were anti-centromere antibody (ACA)-positive compared with 9/27 (33.3%) SSc patients with scores of 0–1. The positivity of anti-Ro-60/SSA were also significantly higher in SSc patients with SGUS grade ≥2 (37.5%) than those with SGUS scores of 0–1 (3.7%). In SSc group, there was no significant difference in auto-antibody profile and organ involvement between patients with fibrosis scores ≥2 and those with scores 0-1.Table 1.Characteristics of the study population included in the studySSc(n =59)pSS(n =56)Idiopathic sicca syndrome(n =32)P- value(SSc vs pSS)P- value(SSc vs idiopathic sicca)P- value(pSS vs idiopathic sicca)Age, mean (SD), years54.8 (12.1)60.5 (11.9)62 (11.2)0.0130.0060.559Female, n (%)53 (89.8)56 (100)28 (87.5)0.0280.7370.015Anti-Ro-60/SSA, n (%)13 (22.0)39 (69.6)7 (21.9)<0.0010.986<0.001ACA, n (%)30 (30.8)8 (14.3)2 (6.3)<0.001<0.0010.238Anti-topoisomerase, n (%)16 (27.1)0 (0)0 (0)<0.001<0.0011.000Max OMERACT US grade ≥ 2, n (%)32 (54.2)35 (62.5)1 (3.1)0.369<0.001<0.001Total SGUS scores, median (IQR)4.0 (6)7.0 (8)0 (1)0.231<0.001<0.001Max fibrosis US grade ≥ 2, n (%)47 (79.7)35 (62.5)15 (46.9)0.0420.0040.263Total fibrosis scores, median (IQR)6 (3)6 (6)4 (4)0.674< 0.0010.006PDS sum scores of four salivary glands, median (IQR)2 (5)0 (4)0 (2)0.1310.1521.000Conclusion:Based on OMERACT definitions for SGUS, more than half of the patients with SSc, especially those with ACA, had salivary gland involvement. Salivary glandular fibrosis is more prominent in patients with SSc than those with pSS and idiopathic sicca syndrome.References:[1]Jousse-Joulin S, et al. Video clip assessment of a salivary gland ultrasound scoring system in Sjogren’s syndrome using consensual definitions: an OMERACT ultrasound working group reliability exercise. Ann Rheum Dis. 2019;78(7):967-73.Disclosure of Interests:None declared
Background:Mechanical stress are one of the pathogenesis of ankylosing spondlitis (AS). During pregnancy, the mechanical overload on the spine and pelvis increases due to gravid uterus. Recently, computed tomography syndesmophyte score (CTSS) has been developed to analysis of the spinal damage in patients with AS. Indeed, CT has higher sensitivity and reliability compared to conventional radiography in the detection of sacroiliitis.Objectives:We aimed to investigate whether pregnancy and delivery affect radiographic progression of spine and SIJ in women with AS based on CT evaluation.Methods:This retrospective study included women aged 19-49 years with AS who performed at least twice CT scans of whole-spine or sacroilliac joints (SIJ) at intervals of 2 to 4 years. To compare the radiographic progression after delivery, we classified into 2 groups: delivery group or controls. Delivery group was restricted to subjects who had the first CT scans ~2 years before delivery and the second CT scans ~2 years after delivery. CTSS (0-522) and SIJ scores (0-40) were used to evaluate the spinal syndesmophyte and erosion, joint space narrowing, and sclerosis of SIJ.Results:A total of 21 women in delivery group and 38 women in controls were included. The median (Q1-Q3) CTSS at baseline in delivery group and controls were 19 (16-23) and 20 (13.25-27.75), and median progression was 1 (0-3) and 0 (0-1) during the median 2.9 year follow-up. The median (Q1-Q3) SIJ scores at baseline in delivery group and controls were 13 (8-22) and 11 (6-22), and median progression was 1.5 (0-3) and 1 (0-2). The CTSS and SIJ scores significantly increased in both groups, but no difference in absolute score changes per time point between was observed. The changes in SIJ scores was comparable according to the delivery methods.Conclusion:This study suggests that pregnancy and delivery had no effect on radiographic progression of spine and SIJ in female with AS.References:[1]de Bruin F, de Koning A, van den Berg R, Baraliakos X, Braun J, Ramiro S. Development of the CT Syndesmophyte Score (CTSS) in patients with ankylosing spondylitis: data from the SIAS cohort. 2018;77(3):371-7.Disclosure of Interests:None declared.
BackgroundInterstitial lung disease (ILD) is the most frequent pulmonary manifestation in patients with Primary Sjögren’s syndrome (pSS). Data on the clinical and radiographic course based on high resolution computed tomography (HRCT) findings are limited.ObjectivesWe aimed to investigate the long-term course and prognostic factors of patients with primary Sjögren syndrome-associated interstitial lung disease (pSS-ILD).MethodsThis single-center, retrospective study included 120 pSS patients who underwent at least two high-resolution computed tomography (HRCT) scans between March 2013 and February 2021. Clinical symptoms, laboratory data, HRCT findings, and pulmonary function test results were collected. Two thoracic radiologists reviewed the HRCT findings.ResultsIn patients with pSS without ILD at baseline (n=81), no development of ILD was found on follow-up (median, 2.8 years). In patients with pSS-ILD (n=39), total disease extent, extent of coarse reticulation, and traction bronchiectasis increased on HRCT, whereas the extent of ground glass opacity (GGO) decreased at follow-up (median, 3.2 years) (eachp<0.001). In progressive group of pSS-ILD (n=19/39, 48.7%), the extent of coarse reticulation and coarseness score of fibrosis were increased at follow-up (p<0.05). Multivariate logistic regression analysis showed that LDH (OR, 1.012) and diffusing capacity for carbon monoxide (OR, 0.922) were independent risk factors for pSS-ILD at baseline. Usual interstitial pneumonia pattern on CT (OR, 15.237) and follow-up duration (OR, 1.403) were independent risk factors for disease progression in patients with pSS-ILD. In response to glucocorticoid and/or immunosuppressants, GGO decreased, whereas the extent of fibrosis increased even after treatment.ConclusionIn pSS patients with no ILD during baseline evaluation, no newly developed ILD was identified during follow-up over two years. Progression occurred in approximately half of the pSS-ILD patients with slow gradual deterioration. The extent of fibrosis increased, even after anti-inflammatory treatment.References[1]Goh NS, Desai SR, Veeraraghavan S, Hansell DM, Copley SJ, Maher TM et al. Interstitial lung disease in systemic sclerosis: a simple staging system.Am J Respir Crit Care Med2008;177:1248–54.[2]Hansell DM, Bankier AA, MacMahon H, McLoud TC, Müller NL, Remy J. Fleischner Society: glossary of terms for thoracic imaging.Radiology2008;246:697–722.[3]Kim YJ, Choe J, Kim HJ, Song JW. Long-term clinical course and outcome in patients with primary Sjögren syndrome-associated interstitial lung disease.Sci Rep2021;11:12827.Figure 1.Changes in HRCT variables in patients with pSS-ILD during the follow-up period.Plots are shown for the total extent (A) ground-glass opacities (GGO) (B), fine reticulation (C), coarse reticulations (D), coarseness score of fibrosis (E), and score of traction bronchiectasis (BE).AcknowledgementsThis research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HC21C0100). This work was also supported by the Soonchunhyang University Research Fund.Disclosure of InterestsNone Declared.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.