Background Primary Sjögren syndrome (pSS) is a systemic autoimmune disease involving exocrine glands, mainly ocular and salivary glands. Salivary gland ultrasound (SGU), of submandibular and parotid glands, in pSS is characterized by hypo/anechoic rounded areas within gland parenchyma, losing the normal homogeneity of the glands (typical SGU)1. SGU is a reliable imaging technique for assessing gland echostructure in pSS2.
Objectives The aim of our study is to evaluate the relation between typical SGU and clinical and laboratory data in pSS
Methods We performed SGU to 100 patients with pSS from our rheumatology department selected randomly from a database. We used a semiquantitative score from 0 to 3. Grades 0 and 1 were considered as normal and grades 2 and 3 were considered as typical for pSS. We retrospectively collected demographics (age, gender, disease duration), clinical (extra-glandular manifestations, parotid swelling and lymphoma) and laboratory data (ESR, CRP, rheumatoid factor (RF), antinuclear antibodies (AAN), anti-SSA and anti-SSB antibodies). We divided the patients into 3 groups depending on their autoimmunity profile. Complete seropositive group were patients with RF, AAN and antiSSA or antiSSB positives simultaneously or sequentially. Simple seropositive group were patients with any positive autoantibody (RF/AAN/antiSSA or antiSSB) but not all of them together. Finally, patients without positive autoantibodies were included in the seronegative group
Results We excluded 7 patients because they were diagnosed with secondary SS. From 93 pSS patients analyzed, 32 (frequency 34.5%) had a typical SGU. Demographics, extra-glandular manifestations and lymphomas were similar between patients with typical SGU and patients with normal SGU. Parotid swelling and longer disease duration were associated with a typical SGU (p<0.05). Patients with positive autoantibodies (AAN, RF, antiSSA and antiSSB) had more frequently a typical SGU. Complete seropositive group had the highest frequency of typical SGU, followed by simple seropositive group. All seronegative patients had a normal SGU. SGU relation with autoimmunity is shown in table 1
Conclusions Longer disease duration and parotid swelling were associated with typical SGU. Typical SGU was associated with positive autoimmunity, moreover all seronegative patients had a normal SGU
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Damjanov N, Milic V, Nieto-González JC, et al. Multiobserver Reliability of Ultrasound Assessment of Salivary Glands in Patients with Established Primary Sjögren Syndrome. J Rheumatol. 2016.
Disclosure of Interest None declared