Background/Purpose: to evaluate if the salivary glands ultrasonographic score (SGUS) is modified during follow-up in primitive Sjögren patients (pSS) and to compare pSS with idiopathic sicca syndromes (non-pSS).

Methods: this study was performed in the Brittany cohort of patients with suspected pSS. All patients had standardized clinical, biological and imaging evaluation. pSS diagnosis was considered according to the AECG criteria. Patients with or without pSS had ultrasonography of both parotid glands and both submandibular glands; they were graded on a 5-point scale (0 to 4). During follow-up, a second ultrasonography was performed. Patients treated with Rituximab were excluded. Salivary-gland ultrasonography was performed by local expert who was unaware of the final diagnosis. We compared the ultrasonographic score between pSS and non-pSS at inclusion and at second evaluation for the sum of the score of the four glands and the maximum score among the four glands.

Results: of the 49 included patients, 29 received a diagnosis of pSS. At baseline, pSS and non-pSS were similar concerning demographics, Schirmer test and salivary flow. Biopsy positivity and SGUS were statistically different at inclusion between pSS and non-pSS (p<0.001). Sum of the scores of the four glands and maximum score among the four glands was respectively of 8.9 and 2.7 for pSS and 2.1 and 0.8 in non-pSS. Percentage of patients with at least one score > 2 was respectively of 75.8 % and 25.0 % in pSS and non-pSS. During follow-up, a second ultrasonography of salivary glands was performed with a mean delay of 1.9 (+/-1.6) years. There was no difference between sum of the score of the four glands and maximum score among the four glands at second ultrasonography examination between pSS and non-pSS. Significant difference between sum of the scores of the four salivary glands and maximum score among the four glands of pSS and non-pSS was still present at second salivary glands ultrasonography with (p<0.001). No difference was found when parotids and submandibular glands were analyzed apart.

Conclusion: with a mean delay of two years, SGUS is not modified, even in patients with pSS. This observation is also effective in parotid and submandibular glands when taken apart.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-ultrasonographic-lesions-of-salivary-glands-evolve-in-sjogren-patients-during-follow-up/