Ultrasonography of major salivary glands: a highly specific tool for distinguishing primary Sjögren’s syndrome from undifferentiated connective tissue diseases

Luciano, N.; Baldini, Chiara; Tarantini, Gaia; Ferro, Ferro; Sernissi, Francesca; Varanini, Valentina; Donati, Valentina; Martini, Daniela; Mosca, Marta; Caramella, Davide; Bombardieri, Stefano

doi:10.1093/rheumatology/kev253

Cited by 30 publications

(20 citation statements)

References 22 publications

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“…El Miedany et al identified in their study a significant correlation between the salivary gland ultrasound score and the histopathological score (r = 0:82, p < 0:001) [30]. Using the ultrasonographic scoring system described by De Vita et al, Luciano et al described a significant correlation between the SGUS score and the minor salivary gland biopsy/focus score (r = 0:484, p < 0:0001) [31]. Analyzing retrospectively the records of 85 suspected pSS patients, Astorri et al identified that an overall concordance between the ultrasound and the histology was 91% [32].…”

Section: Disease Markersmentioning

confidence: 95%

The Utility of Major Salivary Gland Ultrasonographic Parameters in the Diagnosis of Sjögren Syndrome

Caraba

Babalic²,

Iurciuc

et al. 2019

Disease Markers

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Objective. To investigate ultrasonographically the salivary glands and to correlate ultrasonographic parameters with focus score, serum beta-2-microglobulin, and stimulated salivary flow rate. Material and Methods. 32 patients with primary Sjögren’s syndrome (pSS) and 32 healthy controls were enrolled in this case-control study, performed in the Department of Internal Medicine, Division of Rheumatology, “Victor Babeș” University of Medicine and Pharmacy, Timișoara, Romania. All the patients and controls were examined by salivary gland ultrasonography (B-mode, color and spectral Doppler, and sonoelastography), determining the following parameters: salivary gland ultrasonography (SGUS) score, resistive index (RI) of transverse facial artery, and shear wave velocity (SWV). Serum beta-2-microglobulin and stimulated saliva amount were determined in all the patients and controls. Minor salivary gland biopsy with focus score assessment was done in pSS patients. Results. Patients with pSS presented higher SGUS score and parotid and submandibular SWV and reduced RI of transverse facial artery than controls (p<0.0001). In pSS patients, statistically significant correlations were identified between assessed ultrasonographic parameters and focus score, serum beta-2-microglobulin, and respective stimulated saliva flow (p<0.0001). Conclusions. This study highlighted statistically significant correlations between salivary gland ultrasonographic parameters and focus score, serum beta-2-microglobulin, and stimulated saliva flow.

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Section: Disease Markersmentioning

confidence: 95%

The Utility of Major Salivary Gland Ultrasonographic Parameters in the Diagnosis of Sjögren Syndrome

Caraba

Babalic²,

Iurciuc

et al. 2019

Disease Markers

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“…Patients diagnosed with Sjögren's syndrome according to the AECG criteria presented with higher SGUS score compared with patients with UCTD. Setting the SGUS cut‐off score at a value of >2 provided a sensitivity of 65%, a specificity of 96%, a positive predictive value of 95%, and a negative predictive value of 73% for the diagnosis of Sjögren's syndrome .…”

Section: Major Salivary Gland Ultrasonographymentioning

confidence: 99%

Current concepts on Sjögren's syndrome – classification criteria and biomarkers

Jönsson

Brokstad

Jonsson

et al. 2018

European J Oral Sciences

113

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Sjögren's syndrome is a lymphoproliferative disease with autoimmune features characterized by mononuclear cell infiltration of exocrine glands, notably the lacrimal and salivary glands. These lymphoid infiltrations lead to dryness of the eyes (keratoconjunctivitis sicca), dryness of the mouth (xerostomia), and, frequently, dryness of other surfaces connected to exocrine glands. Sjögren's syndrome is associated with the production of autoantibodies because B-cell activation is a consistent immunoregulatory abnormality. The spectrum of the disease extends from an organ-specific autoimmune disorder to a systemic process and is also associated with an increased risk of B-cell lymphoma. Current treatments are mainly symptomatic. As a result of the diverse presentation of the syndrome, a major challenge remains to improve diagnosis and therapy. For this purpose an international set of classification criteria for primary Sjögren's syndrome has recently been developed and validated and seems well suited for enrolment in clinical trials. Salivary gland biopsies have been examined and histopathology standards have been developed, to be used in clinical trials and patient stratification. Finally, ultrasonography and saliva meet the need of non-invasive imaging and sampling methods for discovery and validation of disease biomarkers in Sjögren's syndrome.

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“…The presence of multiple ovoid hypoechoic lesions, often bounded by hyperechoic bands, correlates with markers of more severe disease. These imaging abnormalities have high specificity for the diagnosis, but only moderate sensitivity [50-54]. …”

Section: Diagnosis Of Sjögren's Syndromementioning

confidence: 99%

Sjögren Syndrome and Other Causes of Sicca in Older Adults

Baer

2017

Clinics in Geriatric Medicine

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Synopsis Dry eye and dry mouth symptoms are each reported by up to 30% of persons over the age of 65 years, particularly in women. Multiple factors contribute to these symptoms, but medication side effects are the most common. The evaluation of these symptoms requires measures of ocular and oral dryness, some of which can be done by the geriatrician in a clinic setting. Sjögren syndrome is the prototypic disease associated with dryness of the eyes and mouth and predominantly affects women in their peri- and postmenopausal years of life. The diagnosis requires substantive evidence of autoimmune-induced inflammation targeting the salivary or lacrimal glands. With current classification criteria, the diagnosis can only be established if the patient has antibodies to the SSA (Ro) and/or SSB (La) antigens or a labial gland biopsy showing a characteristic pattern and severity of inflammation, in concert with at least one measure of ocular or oral dryness. A diagnosis is important, since this disease is associated with a substantial increased risk of lymphoma and other forms of morbidity. In addition to topical treatment of the mucosal dryness, patients with Sjögren's syndrome may require treatment with systemic immunomodulatory and immunosuppressive agents to manage a variety of “extraglandular” manifestations.

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Ultrasonography of major salivary glands: a highly specific tool for distinguishing primary Sjögren’s syndrome from undifferentiated connective tissue diseases

Abstract: This study confirmed the good sensitivity and the high specificity of SGUS in differentiating SS from other CTDs.

Cited by 30 publications

References 22 publications

The Utility of Major Salivary Gland Ultrasonographic Parameters in the Diagnosis of Sjögren Syndrome

The Utility of Major Salivary Gland Ultrasonographic Parameters in the Diagnosis of Sjögren Syndrome

Current concepts on Sjögren's syndrome – classification criteria and biomarkers

Sjögren Syndrome and Other Causes of Sicca in Older Adults

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