Department of Rheumatology and Rehabilitation, Faculty of Medicine, Minia University, Minia, Egypt.
Department of Biochemistry, Faculty of Science, Ain Shams University, Cairo, Egypt.
Clin Rheumatol. 2023 Dec;42(12):3351-3360. doi: 10.1007/s10067-023-06763-w. Epub 2023 Sep 18.
INTRODUCTION/OBJECTIVES: systemic sclerosis (SSc) is an autoimmune disorder with multiple organs destruction. This study aimed to identify the ultrasonographic changes of major salivary glands in Egyptian scleroderma patients and to detect their association to different disease manifestations.
Forty-seven SSc patients and 43 apparent healthy volunteers were enrolled. Demographics, inflammatory markers, and autoimmune status were recorded. Ultrasound evaluation of salivary glands was performed. Salivary gland changes' associations were statistically examined with SSc susceptibility and disease manifestations.
Thirty-one SSc patients exhibited glandular pathology (p < 0.0001), compared to controls. Of these abnormalities, SSc patients showed a total parotid gray scale of 2, total submandibular gray scale of 2, total glandular gray scale of 4, and total glandular Doppler signal of 1 at p < 0.0001, compared to the control group. Patients with SSc and glandular pathology had a higher prevalence of arthritis (p = 0.029) and ESR (p = 0.002) than those with normal glandular ultrasound. Significant associations were reported between gray scale ultrasound (GSUS) of total parotid (odds ratio "OR" = 0.4), total submandibular (OR = 0.36), and total glandular (OR = 0.53) with susceptibility to SSc at p < 0.0001. Total glandular GSUS (p = 0.039) and total submandibular power Doppler (p = 0.044) correlated with the SSc duration. Total parotid GSUS (p = 0.008) and total glandular GSUS (p < 0.0001) correlated with Schirmer's test.
Major salivary glands are affected in SSc. Hence, scanning these glands with ultrasound is an additive tool besides the current practice. Key Points • Major salivary gland changes, observed by ultrasonography, are new findings in Egyptian SSc patients. • Ultrasound changes of major salivary glands are associated with inflammatory markers and clinical manifestations of SSc. • Scleroderma ultrasonography scans of the main salivary glands could be added to the routine work.
介绍/目的：系统性硬化症（SSc）是一种伴有多器官损伤的自身免疫性疾病。本研究旨在确定埃及硬皮病患者主要唾液腺的超声变化，并检测其与不同疾病表现的关系。
纳入 47 例 SSc 患者和 43 名健康志愿者。记录人口统计学、炎症标志物和自身免疫状态。对唾液腺进行超声评估。用统计学方法检查唾液腺变化与 SSc 易感性和疾病表现的关系。
与对照组相比，31 例 SSc 患者出现腺体病理学改变（p<0.0001）。这些异常中，SSc 患者的总腮腺灰度值为 2，总颌下腺灰度值为 2，总腺体灰度值为 4，总腺体多普勒信号为 1（p<0.0001），与对照组相比。有腺体超声异常的 SSc 患者关节炎（p=0.029）和 ESR（p=0.002）的患病率高于腺体超声正常的患者。总腮腺（优势比“OR”=0.4）、总颌下腺（OR=0.36）和总腺体（OR=0.53）的灰阶超声（GSUS）与 SSc 易感性呈显著相关（p<0.0001）。总腺体 GSUS（p=0.039）和总颌下腺功率多普勒（p=0.044）与 SSc 病程相关。总腮腺 GSUS（p=0.008）和总腺体 GSUS（p<0.0001）与 Schirmer 试验相关。
SSc 会影响主要唾液腺。因此，超声扫描这些腺体是当前实践的补充工具。关键点：• 通过超声观察到的主要唾液腺变化是埃及 SSc 患者的新发现。• 主要唾液腺的超声变化与 SSc 的炎症标志物和临床表现相关。• 硬皮病患者主要唾液腺的超声检查可以作为常规工作的补充。
