Session Information
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Sicca Syndrome patients represent a diagnostic challenge for the wide variety of etiologies that can afford it. Beta-2 Microglogulin (B2MG) is a non-glycosylated protein, found in all nuclear cells and it is release from an inflammatory stimuli [1]. The use of B2MG to differentiate between subjects with presence of autoimmunity, of those who do not, is under study. Objective: Evaluate the performance of the B2MG in distinguishing Sicca Syndrome of Sjšgren’s from those with non- Sjšgren«s syndrome origin.
Methods:
This is a comparative, cross-sectional study, of diagnostic test type, registered by the local IRB (Registry number RE14-009). We included made four groups of patients: Group 1: Primary Sjšgren Syndrome (pSS), according to the 2002/2012 AECG/ACR classification criteria, Group 2: Secondary Sjšgren Syndrome to Rheumatoid Arthritis or Systemic Lupus Erythematosus, Group 3: Sicca of non-Sjšgren«s syndrome origin, Group 4: Healthy controls. Clinical test included determination of Rheumatoid factor (IgA, IgG and IgM), Anti- Ro/SSA and Anti- La/SSB levels. We record the results of patients who had biopsy of minor salivary gland. We obtained saliva according to Fleissig et al [2]. Salival B2MG was measured using a Human ELISA kit abcam¨. Medians and interquartile ranges were assessed to describe the characteristics of the groups. Finally, we categorize patients into 2 groups: SS (group 1 and 2) and No-SS (groups 3 and 4) for ROC curves.
Results:
Demographic and serological variables from the 256 subjects included in this study are shown in Table 1. In Figure 1 we showed a graphic that compares the performance of different auxiliary diagnostic methods for the SS. A value of B2MG of 0.28 μg/mL (95% CI 0.64 to 0.76), with a sensitivity of 88% and a specificity of 31% can distinguish between SS and non-SS.
Conclusion:
We propose that salival B2MG is an easy, non-invasive tool, as a first-step on a steered screening to differentiate patients with Sjšgren Syndrome of Sicca Syndrome from others etiologies.
Table 1.Demographic and serologic patient variables
|
n= 256 |
Group 1 n=64 |
Group 2 n=64 |
Group 3 n=64 |
Group 4 n=64 |
|
Age (IQR) |
50 (15) |
54 (17) |
55.5 (18) |
47 (18) |
|
Female gender, n (%) |
64 (100%) |
64 (100%) |
62 (97%) |
63 (98%) |
|
Use of xerogenic drugs, n (%) |
28 (44%) |
23 (35.9%) |
46(72%) |
– |
|
Use of steroid drugs, n (%) |
18 (28%) |
27 (42.2%) |
5 (8%) |
– |
|
Use of hydroxychloroquine, n (%) |
30 (47%) |
19 (29.7%) |
9 (14%) |
– |
|
Use of methotrexate, n (%) |
15 (23%) |
30 (46.9%) |
1 (2%) |
– |
|
Use of biologic drugs, n (%) |
0 (0%) |
4 (6.2%) |
1 (1.6%) |
0 |
|
SSA/Ro *, n (%) |
44 (69%) |
10 (17.9%)/56 |
0 (0%)/32 |
– |
|
SSB/La *, n (%) |
14 (22%) |
4 (7.3%)/55 |
0 (0%)/32 |
– |
|
Schirmer test positive*, n (%) |
52 (81%) |
44 (71%)/62 |
40 (63%)/63 |
– |
|
LSG biopsy positive*, n (%) |
54 (87%)/62 |
24 (58.5%)/41 |
0 (0%)/25 |
– |
|
Salivary flow (IQR) |
0.06 (0.06) |
0.06 (0.06) |
0.08 (0.07) |
– |
|
Salivary b2MG (IQR) |
0.71 (0.75) |
0.71 (0.75) |
0.52 (0.55) |
0.35 (0.35) |
|
Serum b2MG (IQR) |
0.77 (0.36) |
0.99 (0.73) |
0.97 (0.58) |
0.87 (0.26) |
IQR: interquartilerange, Labialsalivaryglandbiopsy, b2MG:Beta2MicroglogulinXerogenicdrugs:tramadol, H1antihistamines, anticholinergics, betablockers, calciumchannelblockers, benzodiazepines, diuretics, selectiveinhibitorsofserotoninreuptake.SSA/Ro:Positive >25U/mL,SSB/La:Positive >25 U/mL.Schirmertestpositive:<10mmin5minutes,LSGbiopsypositive:exhibiting focallymphocyticsialadenitiswithafocusscore³1focus / 4 mm2.*Positive/patientswithvariabledetermination 
Disclosure: J. Riega-Torres, None; A. Valdés-Mancha, None; C. Sánchez-Domínguez, None; L. Pérez-Barbosa, None; A. Arana-Guajardo, None; D. Vega-Morales, None; M. A. Garza-Elizondo, None.
To cite this abstract in AMA style:
Riega-Torres J, Valdés-Mancha A, Sánchez-Domínguez C, Pérez-Barbosa L, Arana-Guajardo A, Vega-Morales D, Garza-Elizondo MA. Steered Screening for Sjögren Syndrome in Patients with Sicca Syndrome. Role of Salival Beta-2 Microglogulin [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/steered-screening-for-sjogren-syndrome-in-patients-with-sicca-syndrome-role-of-salival-beta-2-microglogulin/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/steered-screening-for-sjogren-syndrome-in-patients-with-sicca-syndrome-role-of-salival-beta-2-microglogulin/