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.
Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Rozzano, Italy.
Clin Rheumatol. 2020 Apr;39(4):1207-1215. doi: 10.1007/s10067-019-04780-2. Epub 2019 Nov 1.
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.
本研究旨在探讨原发性干燥综合征（pSS）与其他结缔组织病（CTD）患者唾液腺（SG）的超声（US）表现，并评估两组患者 SGUS 异常与自身抗体谱的关系。我们纳入了 81 名患者，其中 45 名被诊断为 Sjögren 综合征（SS）（39 名原发性 SS，6 名继发性 SS），36 名被诊断为其他 CTD。所有患者均接受了干燥症状的前瞻性评估、Schirmer 试验和腮腺及颌下腺 B 型超声评估，所有评估均对诊断设盲。每个 SG 均进行 0-3 分的半定量评分；≥2 分被认为是病理性的。在患者水平和在每个腺体水平上，将 SGUS 受累分为正常或病理性。此外，还为每位患者计算了总 SGUS 评分（0-12 分）和腮腺/颌下腺评分（0-6 分）。还获得了自身免疫实验室数据。SS 患者的所有 SGUS 评分均高于 CTD 患者（p<0.001），且 SS 患者的总体（p<0.001）、腮腺（p<0.001）或颌下腺（p=0.001）SGUS 评分病理性的比例显著高于 CTD 患者。在 SS 患者中，自身抗体的存在与 SGUS 病理性和评分升高显著相关，尤其是在腮腺水平，而在 CTD 患者中，口干和病理性 Schirmer 试验与颌下腺的 SGUS 病理性和评分升高相关（p<0.05）。与其他 CTD 相比，SS 患者的 SGUS 表现出不同程度的异常、腺体受累和相关的自身抗体谱。关键要点： • SS 患者和其他 CTD 患者的 SGUS 异常程度不同。 • SS 患者和其他 CTD 患者的腺体受累和相关自身抗体谱不同。 • SS 患者中抗 Ro60 和抗 Ro52 Ro60 阳性与腮腺受累严重程度相关。
