Background/Purpose: Salivary gland ultrasonography (SGUS) has recently appeared as a promising tool for the diagnosis and the early stratification of patients affected by primary Sjögren’s syndrome (pSS). In particular, the SGUS score has been reported as correlated with the ESSDAI score, suggesting that patients with more prominent pathological findings at the SGUS may have a higher disease activity. In this study, we aimed at correlating the SGUS score with the single domains of the ESSDAI and of the ClinESSDAI in order to better investigate any eventual association and correlation between SGUS abnormalities and pSS clinical and biological features.

Methods: Patients with pSS (AECG 2002) were prospectively enrolled in this study. All subjects had a standardized evaluation which included laboratory testing and a complete rheumatologic evaluation. SGUS was carried out by the same radiologist blinded to the diagnosis and the following US parameters were recorded: size, parenchymal echogenicity and inhomogeneity in the parotid and submandibular glands on both sides. A modified version of the De Vita score was used to grade the echostructure alterations of the salivary glands.

Results: One hundred and forty consecutive pSS patients (137 F: 3 M, age = 56.7±13 yrs) were enrolled in this study. Out of them 59/140 patients showed no pathological findings at the SGUS examination and 81/140 presented at least some mild alterations. The mean SGUS score was 1.97± 2.20 (range 0-8). The mean ESSDAI was 3.10±4.33 (range 0-33). The total SGUS score significantly correlated with both the ESSDAI (r=0.340, p=0.000) and the ClinESSDAI (r=0.263, p=0.002). In particular the biological domain of the ESSDAI were significantly correlated to both partial parotid scores (r=0.379, p=0.000) and submandibular scores (r=0.200, p=0.02). By contrast, only partial parotid scores (but not the partial submandibular scores) significantly correlated with the ClinESSDAI (r=0.253, p=0.03) and, particularly with glandular (r=0.279, p=0.001), ematological (r=0.185, p=0.03) and skin domains (r=0.188, p=0.03). Total and partial parotid SGUS scores inversely correlated with the age of the patients at pSS diagnosis (r=-0.168, p=0.04 and r=-0.208, p=0.01).

Conclusion: This study demonstrated that patients with US pathological findings in their parotid glands, also in the absence of evident glandular swelling, presented a more aggressive disease phenotype. SGUS may therefore be useful in clinical practice to identify patients with subclinical parotid involvement who may deserve a closer monitoring and a more aggressive treatment.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/salivary-gland-ultrasonography-sgus-and-subclinical-parotid-involvement-usefulness-of-sgus-in-the-identification-of-a-subset-of-patients-with-sjogrens-syndrome-at-higher-risk-for-extraglandular-d/