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Abstract Number: 2673

Glandular Ultrasonography in Primary SjöGren Syndrome: Clinical and Laboratory Correlation

Tania Fidelix1, Virginia Trevisani2, Adagmar Andriolo3 and Adriano Czapkowski4, 1Evidence Based Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil, 2Health Evidence Based, Escola Paulista de Medicina, São Paulo, Brazil, 3Clinical Laboratories, Escola Paulista de Medicina, Sao Paulo, Brazil, 4Radiology, Radiology Department- Escola Paulista de Medicina, Sao Paulo, Brazil

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: salivary gland and ultrasonography, Sjogren's syndrome

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Session Information

Date: Tuesday, November 15, 2016

Session Title: Sjögren's Syndrome - Poster II: Clinical Science

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Primary SjogrenÕs syndrome (pSS) is a chronic autoimmune disorder that is characterized clinically by dryness of the eyes (xerophthalmia) and mouth (xerostomia). The assayÕs purpose was to observe which laboratory tests, clinical characteristics or activity index could have correlation with ultrasonography (US) glandular scores in a cohort of 66 patients with xerostomia in pSS, prospectively enrolled from September 2013 to May 2016 in two medical centers.  

Methods: The glandular US score was correlated with clinical and laboratory data in 66 patients with pSS according to American-European Consensus Group. criteria (AECG) (male/female ratio 2/64, mean age 55,55 (11.15) years) and median of disease duration 6.0(2.0-10.0). Imaging findings of US were graded using an ultrasonography score ranging from 0 to 4(1), which was obtained considering the worst score between each parotid and submandibular gland. All laboratory tests were done including Immunoglobulin G  (IgG) level and salivary beta 2 microglobulin. Stimulated salivary flux was measured in the same conditions and hour for every patient, with <0,5 ml/min considered abnormal. The xerostomia inventory validated for portuguese language was applied for all patients by a blind investigator(2). One single rheumatologist was responsible for applying the European Sjšgren Syndrome Disease Activity Index (ESSDAI).

Results: Considering each score value in US, our cohort had almost the majority with 3 an 4 scores (83%).  The correlation between higher US scores and clinical and laboratorial parameters was not found. However, higher US scores were correlated with high IgG levels (p=0,0134) and low salivary flux (p=0,0059).

Conclusion: Salivary gland US is a useful method in visualizing glandular structural changes in patients suspected of having pSS and it may represent a good option as a first-line imaging tool in the diagnostics of the disease. In our cohort it was important to show that more important changes matched with lower salivary flux and more inflammatory process. Maybe the ultrasonographic approach in earlier times of disease can change this scenario.

N

Mean

PD

Median

M’n.

M‡x

P

Salivary Flux
Score 1

8

0.34

0.24

0.28

0.10

0.90

0.0059

Score 2

9

0.19

0.17

0.20

0.01

0.46

Score 3

36

0.11

0.12

0.06**

0.00

0.50

Score 4

10

0.10

0.12

0.03**

0.00

0.32

IGG
Score 1

7

959.57

174.59

951.00

701

1250

0.01034

Score 2

9

1350.33

457.29

1220.00

920

2380

Score 3

32

1409.69

469.63

1286.00*

638

2293

Score 4

9

1959.33

845.20

2100.00**

946

3220

References: 1.   Cornec D et al. Contribution of Gland Salivary Ultrasonography to the Diagnosis of Sjšgren Syndrome. Arthritis Rheum 2013;65:216-225.

2.   Mata ADSP et al. Translation, validation, and construct reliability of a Portuguese version of the Xerostomia Inventory. Oral Diseases 2012;18:293-298.


Disclosure: T. Fidelix, None; V. Trevisani, None; A. Andriolo, None; A. Czapkowski, None.

To cite this abstract in AMA style:

Fidelix T, Trevisani V, Andriolo A, Czapkowski A. Glandular Ultrasonography in Primary SjöGren Syndrome: Clinical and Laboratory Correlation [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/glandular-ultrasonography-in-primary-sjogren-syndrome-clinical-and-laboratory-correlation/. Accessed January 23, 2021.
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