Clinical and Prognostic Significance of Parotid Scintigraphy in 405 Patients with Primary Sjögren’s Syndrome

Ramos-Casals, Manuel; Brito-Zerón, Pilar; Pérez-de-Lis, M.; Díaz-Lagares, Cándido; Bové, Albert; Soto, M.; Jiménez, Iratxe; Belenguer, Rafael; Sisó, Antoni; Muxí, África; Pons, Françesca

doi:10.3899/jrheum.090835

Cited by 54 publications

(35 citation statements)

References 27 publications

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“…Patients with pSS having risk factors for progression to lymphoma should be closely monitored (persistent enlargement of parotid glands, splenomegaly, lymphadenopathy, purpura, leg ulcers, neutropenia, low levels of C4, and mixed cryoglobulinemia) [1,6]. CD4+ lymphocytopenia [2] and severe parotid scintigraphic involvement at diagnosis [7] seem to be useful clinical predictor in two recent studies. The identiWcation of predictive factors is not possible in our study in view of the low number of cases observed making a multivariate regression analysis not possible.…”

Section: Discussionmentioning

confidence: 99%

Parotid gland non-Hodgkin lymphoma in primary Sjögren syndrome

Zénone

2011

Rheumatol Int

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The risk of malignant non-Hodgkin lymphoma is increased in primary Sjögren syndrome. In the literature, most studies evaluating this risk were conducted in tertiary reference university hospital. So, selection bias in series exists, in particular selection of the most severe cases in tertiary reference university care centers. Some studies had also a selection bias because patients were hospitalized (data were obtained from hospital discharge registries) and therefore the more severe cases were considered. Between October 1999 and November 2009, 109 adult patients were admitted to our department of internal medicine (non-university hospital, secondary level of the healthcare system, hospitalized patients and outpatient) with diagnosis of primary Sjögren syndrome. Two cases of parotid gland lymphoma occurred during the period of follow-up. No other lymphoma was detected. In this study, clinically identifiable parotid gland non-Hodgkin lymphoma occurs in 1.8% of patients with primary Sjögren syndrome. Because most non-Hodgkin lymphoma initially involves the neck organs, meticulous imaging studies mainly focused on the cervical regions are recommended in the follow-up of patients with primary Sjögren syndrome. Patients whose main complaint is persistent parotid gland swelling may have a parotid biopsy in order to diagnose non-Hodgkin lymphoma.

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Section: Discussionmentioning

confidence: 99%

Parotid gland non-Hodgkin lymphoma in primary Sjögren syndrome

Zénone

2011

Rheumatol Int

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“…11 Parotid scintigraphy has greater sensitivity (80%) and specificity (86%) 10 and evaluates the grade of involvement of the major salivary glands; severe involvement (grade IV) at diagnosis is prospectively associated with an increased risk of lymphoma and death. 21 Immunological study must include determination of autoantibodies to Ro/SS-A and La/SS-B antigens, which are positive in 50-70% of patients and are the only immunological parameter included in the current criteria, with a low sensitivity (33-46%) but a specificity of 100%. 10 Other parameters that should be tested for, or ruled out, are complement levels, serum monoclonal band, and cryoglobulins (hypocomplementaemia, monoclonal gammopathy, and mixed cryoglobulinaemia are associated with increased risk of lymphoma and death).…”

Section: Haematologicalmentioning

confidence: 99%

Primary Sjogren syndrome

Ramos-Casals

Brito-Zerón

Sisó‐Almirall

et al. 2012

BMJ

295

177

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“…Nonetheless, few studies evaluated the centrality and dispersion of these quantitative scintigraphic indices in well-characterized groups of controls, and the validity and acceptance of such criteria still remain to be established. In which relates to SS, a recent report has shown a correlation between the severity of the scintigraphic involvement and a more pronounced autoimmune involvement with an increased risk to develop systemic features, lymphoma, and a lower survival rate [37]. Other reports also substantiate the relevance of scintigraphy in the assessment of glandular dysfunction and of the disease severity [38,39].…”

Section: Methodsmentioning

confidence: 96%

Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

Gomes¹,

Juodžbalys²,

Fernandes³

et al. 2012

JOMR

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ObjectivesThe purpose of present paper is to critically address the recent advances on diagnostic procedures of Sjögren's syndrome, taking into account the attained local and systemic features of the disease.Material and MethodsA comprehensive review of the available literature regarding to the diagnostic approaches to Sjögren's syndrome was conducted. Eligible studies were identified by searching the electronic literature PubMed, Medline, Embase, and ScienceDirect databases for relevant reports (last search update January 2012) combining the MESH heading term "Sjögren's syndrome", with the words "diagnosis, diagnostic procedures, salivary gland function, ocular tests, histopathology, salivary gland imaging, serology". The authors checked the references of the selected articles to identify additional eligible publications and contacted the authors, if necessary.ResultsPresented article addresses the established diagnostic criteria for Sjögren's syndrome and critically evaluates the most commonly used diagnostic procedures, presenting data from author's own clinical experience. Diagnostic criteria for Sjögren's syndrome are required both by healthcare professionals and patients, namely in order to provide a rational basis for the assessment of the symptoms, establish an individual disease prognosis, and orientate the therapeutic intervention.ConclusionsSjögren's syndrome is quite a common autoimmune disease of which the diagnosis and treatment are not easily established. Due to its systemic involvement, it can exhibit a wide range of clinical manifestations that contribute to confusion and delay in diagnosis. The use of proper diagnostic modalities will help to reduce the time to diagnosis and preserve the health and quality of life of patients with Sjögren's syndrome.

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Clinical and Prognostic Significance of Parotid Scintigraphy in 405 Patients with Primary Sjögren’s Syndrome

Cited by 54 publications

References 27 publications

Parotid gland non-Hodgkin lymphoma in primary Sjögren syndrome

Parotid gland non-Hodgkin lymphoma in primary Sjögren syndrome

Primary Sjogren syndrome

Diagnostic Approaches to Sjögren’s Syndrome: a Literature Review and Own Clinical Experience

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