Salivary gland ultrasound is linked to the autoimmunity profile in patients with primary Sjögren’s syndrome

Nieto‐González, Juan Carlos; Ovalles-Bonilla, J.G.; Estrada, Eduardo; Serrano-Benavente, Belén; Martínez-Barrio, Julia; González-Fernández, C.; González-Benítez, R.D.; Dangond, C. Vergara; Monteagudo, I.; Yurrita, Luis Collado; Naredo, Esperanza; López‐Longo, Francisco Javier

doi:10.1177/0300060518767031

Cited by 7 publications

(5 citation statements)

References 31 publications

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“…The latest was proposed in 2019 by the OMERACT task force and is also focused on parenchymal inhomogeneity (11). Of note, two different SGUS scoring systems provided identical results in this study, and this might be relevant to facilitate, at least in part, the evaluation and the comparison of the previous studies which used different scoring systems (18)(19)(20)(21)(22)(23)(24)(25)(26)(27), although in our study, a bias in classifying the same US image simultaneously at patient bedside using two different, but quite similar, scoring systems could be present.…”

Section: Discussionmentioning

confidence: 53%

“…Although with some limitations for the reasons mentioned above, several studies reported associations between sonographic parenchymal inhomogeneity and clinical, laboratory, and pathological pSSrelated features, such as reduced salivary flow rate, presence of anti-Ro/SSA and/or anti-La/SSB antibody, positive lip biopsy, etc. (18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

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Normal-Appearing Salivary Gland Ultrasonography Identifies a Milder Phenotype of Primary Sjögren's Syndrome

Callegher¹,

Zabotti²,

Giovannini³

et al. 2020

Front. Med.

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Objective: Salivary gland ultrasound (SGUS) is emerging as a valid tool in the management of primary Sjögren's syndrome (pSS). This study aimed to investigate whether pSS patients with normal-appearing or pathological SGUS findings showed different clinical, laboratory, and pathologic pSS-related features, and to compare the results by using two different SGUS scores.Methods: Consecutive pSS patients, according to the ACR-EULAR classification criteria, were evaluated. Salivary glands were scored using the early 1992 score by De Vita et al. and the latest 2019 OMERACT score, both being semiquantitative 0–3 scoring systems focused on ultrasonographic parenchymal inhomogeneity (grades 0 and 1, normal-appearing; grades 2 and 3, pathological). The patients were then divided into two groups: “SGUS normal-appearing” if all the salivary glands had normal-appearing parenchyma (grade 0 or 1), or “SGUS pathological” if the grade was 2 or 3 in at least one salivary gland. The associations between SGUS and pSS-related clinical, laboratory, and pathological features were then investigated in the two groups.Results: One hundred pSS patients were evaluated, the mean age (±SD) was 60.9 ± 12.0 years, and mean disease duration was 11.7 ± 7.2 years. Twenty-nine out of 100 (29%) patients were in the “SGUS normal-appearing” group and 71/100 (71%) were in the “SGUS pathological” group. A normal-appearing SGUS was significantly associated with the absence of anti-La/SSB antibodies (p < 0.001) and normal unstimulated salivary flow rate (p = 0.02) by both univariate and multivariate analyses. By univariate analysis, a normal-appearing SGUS was significantly associated also with the absence of rheumatoid factor (p = 0.002) and of serum monoclonal component (p = 0.003), ESSDAI < 5 (p = 0.03), and with a negative lip biopsy (p = 0.029). No associations were found with other items, including anti-Ro/SSA (p = 0.145), Schirmer's test (p = 0.793), ESSPRI (p = 0.47), and demographic data. No differences in these results were observed by using the two SGUS scoring systems.Conclusion: The SGUS allowed the identification of different phenotypes of pSS, and different SGUS scores focused on salivary gland inhomogeneity may be effective to this end.

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Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Normal-Appearing Salivary Gland Ultrasonography Identifies a Milder Phenotype of Primary Sjögren's Syndrome

Callegher¹,

Zabotti²,

Giovannini³

et al. 2020

Front. Med.

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“…Additionally, we demonstrated that patients with abnormal SGUS scores did not differ significantly from those with normal findings with regard to age at examination, age at diagnosis, or disease duration in accordance with previous studies. 15,35,39 Mossel et al 35 found that there is no difference in disease duration between patients with medium positive or high-positive SGUS scores. It could be postulated that after certain disease duration there is stabilization in the SGUS lesions, as happened with the production of saliva.…”

Section: Discussionmentioning

confidence: 99%

“…12,13 Several studies demonstrated good correlation of SGUS with other imaging modalities for diagnosing SS, 14 autoantibodies and dry mouth and eye symptoms, and minor pathological changes in the salivary gland. [15][16][17] While many studies have focused on primary SS, limited studies examined the role of SGUS in patients with secondary SS. 18 The aims of this study were to 1) evaluate the performance of SGUS for the diagnosis of sSS in patients with SLE, and 2) identify the relationship between SGUS findings with clinical and laboratory findings in patients with SLE.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of salivary gland ultrasonography for secondary Sjögren syndrome in patients with systemic lupus erythematosus

Hammam

Elzohri

Elsonbaty

et al. 2022

Lupus

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Background Salivary gland ultrasound (SGUS) is a reliable technique for assessing the salivary glands in patients with primary Sjögren’s syndrome (SS); however, the role of SGUS for diagnosis of secondary SS (sSS) in patients with systemic lupus erythematosus (SLE) was not examined. Objective To assess the diagnostic value of SGUS for sSS in patients with SLE, and to investigate the relationship between SGUS findings with clinical and laboratory characteristics of patients with SLE. Patients and methods This cross-sectional study included 49 patients with SLE. The diagnosis of sSS was confirmed according to the 2016 ACR/EULAR criteria. Salivary gland US was performed for all patients and graded using a validated Hočevar scoring system. A complete clinical and laboratory workup for SLE was assessed. Schirmer’s test and the ocular staining were performed. Results Of the 49 patients with a mean age of 30.2 ± 9.6 years, 98% were female. 19 (38.8%) had sSS. SGUS changes consistent with sSS (≥17) were found in 29 (59.2%) of the patients. Patients with higher SGUS score had more sicca findings as well as positive anti-Ro, anti-La antibodies, and poorer psychological stress (p < 0.05). The SGUS (≥17) showed a sensitivity of 84.2% and a specificity of 56.7% for sSS diagnosis, with an area under the curve of 0.77 (95% CI: 0.63, 0.91). Conclusion We propose salivary gland ultrasound as a non-invasive method in the diagnostic workup for sSS in patients with SLE. Further studies to confirm the diagnostic value of SGUS in a larger sample of patients with sSS will be necessary.

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“…These associations could help to select a more severe subset of patients with pSS. 35,36 On the other hand, age-related artifacts can be a confusing factor. Future studies will help to clarify the diagnostic, classification or prognostic rule of SGU in the management of patients with EOpSS.…”

Section: Bronchi and Lungmentioning

confidence: 99%

A journey inside the elderly-onset primary Sjögren’s syndrome, looking for useful tips for the geriatrician

Manzo¹,

Castagna²,

Ruotolo

2022

Geriatr Care

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Primary Sjögren’s syndrome (pSS) is a systemic autoimmune rheumatic disease where xerophthalmia, xerostomia and presence of anti-SSA and anti-SSB antibodies are typical features. Its prevalence is higher in over-65 aged population than in other age groups. In the elderly, pSS diagnosis comes up against a whole series of critical points that may favor its misdiagnosis. The aim of our article is to discuss the most relevant of them: the frequent occurrence of a seronegative subset, the presence of systemic features not related to sicca syndrome, the sicca syndrome as iatrogenic manifestation and the possibility of a biopsy false negative of labial salivary glands.

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Salivary gland ultrasound is linked to the autoimmunity profile in patients with primary Sjögren’s syndrome

Cited by 7 publications

References 31 publications

Normal-Appearing Salivary Gland Ultrasonography Identifies a Milder Phenotype of Primary Sjögren's Syndrome

Normal-Appearing Salivary Gland Ultrasonography Identifies a Milder Phenotype of Primary Sjögren's Syndrome

Diagnostic value of salivary gland ultrasonography for secondary Sjögren syndrome in patients with systemic lupus erythematosus

A journey inside the elderly-onset primary Sjögren’s syndrome, looking for useful tips for the geriatrician

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