Ultrasonography of Major Salivary Glands in Primary Sjögren’s Syndrome: Identification of Distinct Evolving Patterns in the Long-Term Follow-up

Francesco Ferro¹, Nicoletta Luciano ¹, Gianmaria Governato ¹, Elena Elefante ², Marta Mosca ², Valentina Donati ³ and Chiara Baldini ¹, ¹Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy, Pisa, Italy, ²Rheumatology Unit, Department of clinical and experimental medicine, University of Pisa, Pisa, Italy, ³University of Pisa, Pisa

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: sialoadenitis and ultrasonography, Sjogren's syndrome

Session Information

Date: Monday, November 11, 2019

Title: Sjögrenʼs Syndrome – Basic & Clinical Science Poster II

Session Type: Poster Session (Monday)

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

Background/Purpose: to evaluate the longitudinal changes of major salivary glands ultrasonography (SGUS) in primary Sjögren’s Syndrome (pSS) and to investigate its relationship with patients’ imaging pattern of presentation.

Methods: Patients with pSS underwent a complete SGUS examination at baseline and subsequently during follow-up. The echostructure of each gland on B-mode images was graded on a 5-point scale (0–4), and a SGUS score ≥2 was defined as pathological. Hypo-anechoic areas in the glands were defined as isolated (< 25% of the surface), localized (25-50%) and diffuse-scattered ( >50%). Number of intra-parotid lymph nodes, presence of hyperechoic bands in more than 50% of the parenchyma and gland size were also recorded.

Results: We included 133 pSS patients (2M:131F, mean age 51±14 yrs) followed for a median follow-up of 24 months (IQR, 12-36 months). At baseline, 48/133 (36.1%) patients had a normal SGUS pattern, 14/133 (10.5%) presented a SGUS pattern characterized by mild inhomogeneity in the glands with no hypo-anechoic areas and 71/133 (53.4%) had a SGUS score ≥2 with a number of hypo-anechoic areas varying greatly among subjects. Patients with a normal SGUS pattern presented less frequently hypergammaglobulinemia, Rheumatoid Factor, anti-Ro/SSA and anti-LA-SSB positivity, whereas patients with a SGUS score ≥2 were significantly younger, had more frequently a history of chronic recurrent parotitis and presented a higher focus score in their labial glands, and a lower unstimulated salivary flow (p< 0.01). At the end of the follow-up, we did not observe any significant change in the number of hypo-anechoic areas; by contrast, 36/133 (27%) patients presented a variation in the number of intra-parotid lymph nodes and 50/133 (37.6%) presented an increase in salivary gland fibrosis and/or a decrease in glandular size. Considering patients’ imaging pattern of presentation, pSS subjects with normal SGUS pattern at the baseline had significantly lower rates of new damage (p=0.001) when compared with the other two imaging patterns.

Conclusion: SGUS pattern of presentation may predict damage accrual in pSS, allowing to personalized medical treatments in clinical practice.

Disclosure: F. Ferro, None; N. Luciano, None; G. Governato, None; E. Elefante, None; M. Mosca, None; V. Donati, None; C. Baldini, None.

To cite this abstract in AMA style:

Ferro F, Luciano N, Governato G, Elefante E, Mosca M, Donati V, Baldini C. Ultrasonography of Major Salivary Glands in Primary Sjögren’s Syndrome: Identification of Distinct Evolving Patterns in the Long-Term Follow-up [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/ultrasonography-of-major-salivary-glands-in-primary-sjogrens-syndrome-identification-of-distinct-evolving-patterns-in-the-long-term-follow-up/. Accessed .

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