Date: Saturday, November 6, 2021
Session Title: Sjögren's Syndrome – Basic & Clinical Science Poster (0296–0322)
Session Type: Poster Session A
Session Time: 8:30AM-10:30AM
Background/Purpose: Primary Sjögren’s syndrome is a systemic autoimmune disease characterized by dryness of the mouth and eyes. The impact of the disease on salivary glands can be assessed in three different ways: by salivary gland histopathology, measuring salivary flow and salivary gland ultrasonography. To understand the relative value of these different approaches for disease evaluation, it is crucial to understand the relationship between them. As we are in the unique position to explore this relationship in the parotid gland, we aimed to assess construct validity between the three different modalities in the same parotid gland.
Methods: Consecutive patients underwent a diagnostic work-up including a parotid gland biopsy, collection of stimulated parotid gland saliva and parotid ultrasonography. Patients who were classified as primary Sjögren’s syndrome according to the ACR-EULAR criteria were included. Construct validity was assessed using Spearman’s correlation coefficients.
Results: A total of 41 patients with primary Sjögren’s syndrome were included. All patients completed a full work-up within a mean time interval of 2.6 months. Correlations between histopathological items and stimulated parotid salivary flow were poor to fair (ρ=-0.123 for focus score and ρ=-0.259 for percentage of CD45+ infiltrate). Likewise, poor correlations were observed between stimulated parotid salivary flow and parotid ultrasonography (ρ=-0.196). Moderate to good associations were found between histopathological items and parotid ultrasound scores (total ultrasound score: ρ=0.510 for focus score and ρ=0.560 for percentage of CD45+ infiltrate; homogeneity: ρ=0.574 for focus score and ρ=0.633 for percentage of CD45+ infiltrate).
Conclusion: Parotid gland salivary flow was not related to parotid gland histology, nor to parotid gland ultrasonography. Although pSS associated ultrasonographic findings correlated to some extent with the amount of inflammatory infiltrate in the parotid gland biopsy, we conclude that the three modalities that evaluate salivary gland involvement assess different (or at best partly related) constructs. Therefore, histopathology, salivary flow and ultrasonography are complementary measurements and cannot directly replace each other in the work-up of pSS.
To cite this abstract in AMA style:van Ginkel M, Mossel E, Haacke E, Arends S, Liefers S, Delli K, van Nimwegen J, Stel A, Spijkervet F, Vissink A, van der vegt B, Kroese F, Bootsma H. Histopathology, Salivary Flow and Ultrasonography of the Parotid Gland: Three Complementary Measurements in Primary Sjögren’s Syndrome [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/histopathology-salivary-flow-and-ultrasonography-of-the-parotid-gland-three-complementary-measurements-in-primary-sjogrens-syndrome/. Accessed June 2, 2023.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/histopathology-salivary-flow-and-ultrasonography-of-the-parotid-gland-three-complementary-measurements-in-primary-sjogrens-syndrome/