Rheumatic disorders affecting the head and neck: underestimated diseases

Knopf, Andreas; Baş, Murat; Chaker, Adam; Straßen, Ulrich; Pickhard, Anja; Stark, Thomas; Lahmer, Tobias; Thürmel, Klaus

doi:10.1093/rheumatology/ker213

Cited by 37 publications

(35 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although otolaryngologic manifestations of various rheumatic diseases have been well described, awareness among otolaryngologists regarding these manifestations is negligible. [2][3][4][5][6][7][8][9] Early and accurate diagnosis with prompt treatment or referral to specialists may prevent morbidity and mortality related to these diseases. The present study was designed to assess the understanding and practice about various ENT problems of rheumatic diseases amongst otolaryngologists.…”

Section: Introductionmentioning

confidence: 99%

Otolaryngologic Manifestations of Various Rheumatic Diseases: Awareness and Practice Among Otolaryngologists

Gera

Kumar

2015

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

Wegener's granulomatosis, Sarcoidosis, Sjög-ren's Syndrome, Behçet disease, Systemic lupus erythematosus, relapsing polychondritis, Churg-Strauss syndrome and Cogan syndromes are rheumatic diseases commonly encountered by otolaryngologists. The present study was designed to assess the understanding and practice about various ENT problems of rheumatic diseases amongst otolaryngologists. A group of 29 otolaryngologists was asked to fill questionnaire which was based on knowledge and practice of otolaryngologists about various otolaryngologic manifestations of rheumatic diseases. Chronic sinusitis was most frequently seen followed by recurrent oral ulcers while spontaneous septal perforation was most infrequently seen symptom by participants. Otolaryngologists showed high index of suspicion and confidence for Wegener's granulomatosis in comparison to other rheumatic diseases. There was no difference noted in practice of otolaryngologists of tertiary care centers and other practitioners. Eighty two percent of participants felt, they were not adequately trained about these diseases. Most of them (93 %) felt that knowledge of such diseases is also necessary for post graduate training in Otolaryngology. Though otolaryngologists are aware of otolaryngologic manifestations of Rheumatic diseases but their index of suspicion, practical implication of knowledge and confidence for evaluation of such diseases is low. Educational sector should define a better medical curriculum for training in Otorhinolaryngology, head and neck surgery.

show abstract

Section: Introductionmentioning

confidence: 99%

Otolaryngologic Manifestations of Various Rheumatic Diseases: Awareness and Practice Among Otolaryngologists

Gera

Kumar

2015

Indian J Otolaryngol Head Neck Surg

View full text Add to dashboard Cite

show abstract

“…Its diagnosis is usually based on the revised American-European Consensus Group (AECG) criteria, comprising ocular and oral symptoms, objective parameters of ocular and oral impairment, SS-A/B antibodies, and histological proof of lymphocytic foci after minor salivary gland biopsy [15] , or the set of classification criteria of the American College of Rheumatology (ACR) [16,17] . The assessment of oral involvement especially is the subject of major discussion.…”

Section: Diffuse Parotid Gland Diseasesmentioning

confidence: 99%

Ultrasound Elastography in Diffuse and Focal Parotid Gland Lesions

Mansour

Hofauer

Knopf³

2017

ORL

View full text Add to dashboard Cite

In Europe, ultrasound (US) is the diagnostic gold standard for the visualisation of parotid gland disorders. While high-resolution B-mode US reliably visualises focal lesions, its diagnostic capacity to distinguish tumour entities or to characterise diffuse lesions remains poor. Strain elastography (SE) and shear wave elastography (SWE) are novel imaging techniques that provide additional information about tissue elasticity. SE analyses the strain or displacement in response to force or compression and, therefore, shows the relative tissue elasticity within a selected region of interest (ROI). Recent studies suggest that SE might be able to predict parotid gland malignancy. In SWE, push pulses generate localised displacements within an ROI that describes mechanical tissue properties expressed in absolute values. Recent studies indicate that SWE can predict tissue fibrosis in different organs. This review article highlights the current role of SE and SWE modalities in diffuse and focal changes of the parotid gland.

show abstract

“…In general, isolated manifestations in the head and neck are uncommon, but in various disorders possible and sometimes identified as limited forms. In other autoimmune diseases, characteristic symptoms in the head and neck occur typically [1] . The most common symptoms in the head and neck, which might be associated with autoimmune disorders, are facial palsy, recurrent epistaxis, dyspnea or dysphonia, otorrhea, rhinorrhea, facial or cranial pain, lymphadenopathy, but most frequently sicca symptoms and an enlargement of the salivary glands [1] .…”

Section: Introductionmentioning

confidence: 99%

“…In other autoimmune diseases, characteristic symptoms in the head and neck occur typically [1] . The most common symptoms in the head and neck, which might be associated with autoimmune disorders, are facial palsy, recurrent epistaxis, dyspnea or dysphonia, otorrhea, rhinorrhea, facial or cranial pain, lymphadenopathy, but most frequently sicca symptoms and an enlargement of the salivary glands [1] . Therefore, typical sites for the manifestations of autoimmune diseases are the middle ear, the nasal cavity and the paranasal sinuses, lymph nodes, the cranial nerves, cartilaginous structures (such as the auricle, the nasal septum, or the larynx), and the glands located in the head and neck, more frequently the salivary than the lacrimal glands.…”

Section: Introductionmentioning

confidence: 99%

“…The extrapulmonary manifestation of sarcoidosis in the cervical lymph nodes or salivary glands, occasionally combined with uveitis and palsy of the facial nerve constituting the complete picture of Heerfordt syndrome, is another frequent autoimmune disorder in the head and neck. Manifestations of a granulomatosis with polyangiitis (GPA) of the parotid glands are less frequent occurring examples for autoimmune alterations of the salivary glands [1] .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biomarkers in Autoimmune Salivary Gland Disorders: A Review

Hofauer

Thuermel

Gahleitner

et al. 2017

ORL

View full text Add to dashboard Cite

Salivary glands are frequent sites of manifestations of autoimmune disorders in the head and neck. Sjögren syndrome, sarcoidosis, granulomatosis with polyangiitis, and IgG4-related sialadenitis represent the most important autoimmune salivary gland disorders. Due to the lack of specific symptoms, diagnosis of these conditions remains a challenge. Diagnosis is usually based on classification criteria involving clinical tests, histopathological evaluation, and serological examinations. Depending on the disease, biomarkers are of different value and have to be interpreted carefully. In Sjögren syndrome, antibodies against Ro/SS-A and La/SS-B are essential and part of established classification criteria. In sarcoidosis, biomarkers such as angiotensin-converting enzyme, serum amyloid A, adenosine deaminase, and soluble interleukin-2 receptor are not suitable to confirm a diagnosis due to low sensitivity and specificity, but allow a differentiation between active and inactive disease. In patients with suspected granulomatosis with polyangiitis, positivity for anti-neutrophil cytoplasmic antibodies (ANCA) allows a diagnosis without histopathological confirmation in selected cases. In the head and neck, limited manifestations are common, in which less patients are positive for ANCA and histopathological confirmation is required. Diagnosis of IgG4-related sialadenitis solely based on elevated IgG4 serum levels is not possible. The concentration of blood plasmablasts is reported to have a higher diagnostic value.

show abstract

Rheumatic disorders affecting the head and neck: underestimated diseases

Cited by 37 publications

References 13 publications

Otolaryngologic Manifestations of Various Rheumatic Diseases: Awareness and Practice Among Otolaryngologists

Otolaryngologic Manifestations of Various Rheumatic Diseases: Awareness and Practice Among Otolaryngologists

Ultrasound Elastography in Diffuse and Focal Parotid Gland Lesions

Biomarkers in Autoimmune Salivary Gland Disorders: A Review

Contact Info

Product

Resources

About