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Ultrasound salivary gland involvement in Sjogren’s syndrome vs. other connective tissue diseases: is it autoantibody and gland dependent?

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Abstract

Abstract

This study aims to investigate ultrasound (US) findings on salivary glands (SG) in patients with Sjögren syndrome (SS) vs. other connective tissue diseases (CTDs) and to assess the relationship of SGUS abnormalities with autoantibody profile in both groups. We enrolled 81 patients, 45 diagnosed with SS (39 with primary SS, 6 with secondary SS) and 36 diagnosed with other CTDs. All patients underwent a prospective evaluation of sicca symptoms, a Schirmer’s test, and a B-mode US assessment of the parotid and submandibular glands, all blinded to the diagnosis. Each SG was semi-quantitatively scored 0–3; a grade ≥ 2 was considered pathological. SGUS involvement was classified as normal or pathological at the patient level and for each pair at the gland level. In addition, a total SGUS score of 0–12 and a parotid/submandibular score of 0–6 were calculated for each patient. Autoimmunity laboratory data were also obtained. All SGUS scores were higher in SS patients than in those with CTD (p < 0.001) and significantly more SS patients showed a pathological global (p < 0.001), parotid (p < 0.001), or submandibular (p = 0.001) US score compared with CTD patients. In SS patients, the presence of autoantibodies was significantly associated with pathological SGUS and higher scores, particularly at the parotid level, while in CTD patients, xerostomia and a pathological Schirmer’s test were associated with pathological US and higher scores at the submandibular level (p < 0.05). SGUS showed a different grade of abnormality, site involvement, and associated autoantibody profile in SS patients as compared with other CTD.

Key Points

• Patients with SS and other CTDs showed different grades of SGUS abnormality.

• Patients with SS and other CTDs showed different gland involvement and associated autoantibody profiles.

• Anti-Ro60 and anti-Ro52 Ro60 positivity were associated with the severity of parotid involvement in SS patients.

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Acknowledgments

The authors would like to thank the Spanish Society of Rheumatology for their help in the English language editing throughout the manuscript preparation process.

Funding

This study has no financial support.

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Authors and Affiliations

  1. Department of Rheumatology, Bone and Joint Research Unit, Hospital Universitario Fundación Jiménez Díaz, IIS Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Av. Reyes Católicos, 2, 28040, Madrid, Spain

    Giuliana Maria Concetta La Paglia, Olga Sanchez-Pernaute, Fredeswinda Romero-Bueno, Sheila Recuero, Pablo Eder Borges, Gabriel Herrero-Beaumont & Esperanza Naredo

  2. Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Rozzano, Italy

    Giuliana Maria Concetta La Paglia

  3. Rheumatology Unit, Department of Medicine, University of Perugia, Perugia, Italy

    Alessia Alunno & Roberto Gerli

  4. Department of Immunology, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Maria José Martínez-Becerra

  5. Biostatistics Unit, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain

    Ignacio Mahillo-Fernández

  6. Department of Social Psychology and Methodology, Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain

    Jesús Garrido

Authors
  1. Giuliana Maria Concetta La Paglia
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  2. Olga Sanchez-Pernaute
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  3. Alessia Alunno
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  4. Maria José Martínez-Becerra
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  5. Fredeswinda Romero-Bueno
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  6. Sheila Recuero
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  7. Pablo Eder Borges
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  8. Ignacio Mahillo-Fernández
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  9. Jesús Garrido
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  10. Roberto Gerli
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  11. Gabriel Herrero-Beaumont
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  12. Esperanza Naredo
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Contributions

Study design: E.N.; GMC. LP. Acquisition of data: GMC. LP; E.N; O.SP.; MJ. MB.; F. RB.; S. R.; PE. B. Analysis and interpretation of data: GMC. LP; E.N.; O.SP.; A.A.; MJ. MB.; F. RB.; S. R.; PE. B.; I. MF.; J.G.; R.G.; G. H-B. Manuscript preparation: E.N.; GMC. LP; J.G. Manuscript critical revision: GMC. LP; E.N; O.SP.; A.A.; MJ. MB.; F. RB.; S. R.; PE. B.; I. MF.; J.G.; R.G.; G. H-B. Final approval: GMC. LP; E.N.; O.SP.; A.A.; MJ. MB.; F. RB.; S. R.; PE. B.; I. MF.; J.G.; R.G.; G. H-B.

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Correspondence to Esperanza Naredo.

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La Paglia, G.M.C., Sanchez-Pernaute, O., Alunno, A. et al. Ultrasound salivary gland involvement in Sjogren’s syndrome vs. other connective tissue diseases: is it autoantibody and gland dependent?. Clin Rheumatol 39, 1207–1215 (2020). https://doi.org/10.1007/s10067-019-04780-2

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  • DOI: https://doi.org/10.1007/s10067-019-04780-2

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