Background/Purpose: The aim of the study was to assess the diagnostic value of salivary gland ultrasonography (SGUS) as a single test for the detection of primary sjogren’s syndrome (pSS) and to examine the prognostic factors for severe structural changes of major salivary glands based on SGUS scoring system.

Methods: Patients with pSS (n = 80) and idiopathic sicca syndrome (n = 42) were evaluated using a SGUS scoring system (0-48 scale) consisted of five SGUS parameters: parenchymal echogenicity, parenchymal homogeneity, number of hypoechoic areas, hyperechogenic reflections, and clearness of salivary gland posterior borders of both parotid and submandibular glands. The volumes and parenchymal power Doppler signal were also assessed. A multivariate regression was performed to determine factors associated with higher SCUS score.

Results: Patients with pSS revealed a significant higher SGUS score in comparison with controls (median (IQR): 25.0 (13.75) vs 6.5 (3.5), P < 0.001). The SGUS cut-off ≥ 12 showed a sensitivity of 82.5%, a specificity of 92.9%, a positive predictive value of 95.7%, and a negative predictive value of 73.6% for pSS diagnosis. There was no significant difference in the volumes between pSS and controls. Double positivity of anti Ro/SS-A and La/SS-B was independently associated with higher SGUS score (β = 5.45, p = 0.009). The SGUS score was also associated with unstimulated salivary flow test (USFR), rheumatoid factor, and IgG.

Conclusion: A new imaging modality, SGUS could be used as a highly specific diagnostic tool in pSS. Our study demonstrates double positivity of anti Ro/SS-A and La/SS-B could independently predict the severe structural damage of major salivary glands in pSS.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prognostic-significance-of-double-positive-anti-ross-a-and-lass-b-antibodies-in-patients-with-primary-sjogrens-syndrome-prospective-salivary-gland-ultrasound-study/