Ultrasound salivary gland involvement in Sjogren’s syndrome vs. other connective tissue diseases: is it autoantibody and gland dependent?

Paglia, Giuliana Maria Concetta La; Sánchez‐Pernaute, Olga; Alunno, Alessia; Martínez-Becerra, Maria José; Romero-Bueno, Fredeswinda; Recuero, Sheila; Borges, Pablo Eder; Mahíllo‐Fernández, Ignacio; Garrido, Jesús; Gerli, Roberto; Herrero‐Beaumont, Gabriel; Naredo, Esperanza

doi:10.1007/s10067-019-04780-2

Cited by 23 publications

(17 citation statements)

References 20 publications

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“…Interestingly, our ndings were similar to a recent study in adults evaluating SGUS in patients with connective tissue diseases including: SLE, MCTD, and undifferentiated connective tissue disease (UCTD) (with the majority of patients having SLE). This study found pathologic SGUS ndings in 27% of patients with connective tissue diseases including SLE [19]. The authors from this study observed that abnormal SGUS seemed to correlate with oral dryness symptoms and abnormal tear production although this was not observed in our patient population.…”

Section: Discussioncontrasting

confidence: 52%

Findings and Feasibility of Major Salivary Gland Ultrasound in Childhood-Onset Systemic Lupus Erythematosus: A Pilot Study

McDonald

Vega‐Fernandez

Ting

2021

Preprint

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Background: Childhood-onset systemic lupus erythematosus (cSLE) is a complex autoimmune disorder with multi-organ manifestations and can be associated with other rheumatic diseases including Sjögren’s syndrome (SS). Salivary gland ultrasound (SGUS) represents a noninvasive tool to screen for salivary gland disease in rheumatic disease patients. The aims of this cross-sectional study were to determine feasibility of major SGUS in a clinic setting and to identify characteristics in a cohort of cSLE patients (without confirmed SS) that may be associated with salivary gland abnormalities consistent with secondary SS.Methods: Patients with SLE onset prior to age 18 were recruited. Patients completed questionnaires rating symptoms and underwent major SGUS examination. Disease and demographic differences were compared between cSLE patients with abnormal SGUS vs. cSLE patients with normal SGUS using t-tests and Fisher’s exact tests.Results: 31 cSLE patients were recruited, 84% were female, 55% were Caucasian. The average disease duration among all patients was 5 years. Average time to complete the SGUS examination and scoring protocol was 7 minutes. 35% of SGUS scores were abnormal and significantly associated with IgG level at diagnosis, and anti-Ro and anti-La antibodies.Conclusions: This is one of the first studies to our knowledge that assesses major SGUS in a cohort of patients with cSLE without prior diagnoses of SS. The SGUS protocol was feasible to perform by rheumatologists in a clinic setting. Although the sample size was small, SGUS abnormalities were identified in one-third of patients. IgG level at diagnosis and anti-Ro and anti-La antibodies may be associated with SGUS abnormalities.

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Section: Discussioncontrasting

confidence: 52%

Findings and Feasibility of Major Salivary Gland Ultrasound in Childhood-Onset Systemic Lupus Erythematosus: A Pilot Study

McDonald

Vega‐Fernandez

Ting

2021

Preprint

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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: 56%

“…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%

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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“…Interestingly, our ndings were similar to a recent study in adults evaluating SGUS in patients with connective tissue diseases including: SLE, MCTD, and undifferentiated connective tissue disease (UCTD) (with the majority of patients having SLE). This study found pathologic SGUS ndings in 27% of patients with connective tissue diseases including SLE [18]. The authors observed that abnormal SGUS seemed to correlate with oral dryness symptoms and abnormal tear production although this was not seen amongst our pediatric population.…”

Section: Discussionmentioning

confidence: 61%

Findings and Feasibility of Major Salivary Gland Ultrasound in Childhood-Onset Systemic Lupus Erythematosus: A Pilot Study

McDonald

Vega‐Fernandez

Ting

2020

Preprint

View full text Add to dashboard Cite

Background: Childhood-onset systemic lupus erythematosus (cSLE) is a complex autoimmune disorder with multi-organ manifestations and can be associated with other rheumatic diseases including Sjögren’s syndrome (SS). Salivary gland ultrasound (SGUS) represents a noninvasive tool to screen for salivary gland disease in rheumatic disease patients. The aims of this cross-sectional study were to determine feasibility of major SGUS in a clinic setting and to identify characteristics in a cohort of cSLE patients (without confirmed SS) that may be associated with salivary gland abnormalities consistent with secondary SS.Methods: Patients with SLE onset prior to age 18 were recruited. Patients completed questionnaires rating symptoms and underwent major SGUS examination. Disease and demographic differences were compared between cSLE patients with abnormal SGUS vs. cSLE patients with normal SGUS using t-tests and Fisher’s exact tests.Results: 31 cSLE patients were recruited, 84% were female, 55% were Caucasian. The average disease duration among all patients was 5 years. Average time to complete the SGUS examination and scoring protocol was 7 minutes. 35% of SGUS scores were abnormal and significantly associated with IgG level at diagnosis, and anti-Ro and anti-La antibodies.Conclusions: This is the first study to assess major SGUS in a cohort of patients with cSLE without prior diagnoses of SS. The SGUS protocol was feasible to perform by rheumatologists in a clinic setting. Although the sample size was small, SGUS abnormalities were identified in one-third of patients. IgG level at diagnosis and anti-Ro and anti-La antibodies may be associated with SGUS abnormalities.

show abstract

Ultrasound salivary gland involvement in Sjogren’s syndrome vs. other connective tissue diseases: is it autoantibody and gland dependent?

Cited by 23 publications

References 20 publications

Findings and Feasibility of Major Salivary Gland Ultrasound in Childhood-Onset Systemic Lupus Erythematosus: A Pilot Study

Findings and Feasibility of Major Salivary Gland Ultrasound in Childhood-Onset Systemic Lupus Erythematosus: A Pilot Study

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

Findings and Feasibility of Major Salivary Gland Ultrasound in Childhood-Onset Systemic Lupus Erythematosus: A Pilot Study

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