Lin Ching-Tsai, Chen Der-Yuan, Chen Yi-Hsing, Lai Chien-Chen, Tang Kuo-Tung
Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung 407, Taiwan.
Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan.
Life (Basel). 2024 Aug 22;14(8):1043. doi: 10.3390/life14081043.
Primary Sjogren's syndrome (pSS) is often concomitant with fibromyalgia (FM). Salivary gland sonography aids in the diagnosis of pSS. We aimed to discover, in primary FM patients, the presence of pSS in undiagnosed patients through salivary gland sonography. We prospectively recruited 42 primary FM patients. FM symptoms were evaluated based on the revised Fibromyalgia Impact Questionnaire (FIQR). Salivary gland sonography was performed. Patients with positive findings underwent salivary gland biopsy. Comparisons were undertaken using the Mann-Whitney U tests and Chi-squared test. In primary FM patients, the prevalence of dry eye was 83%, and dry mouth was 90%. The salivary gland sonographic score did not differ between patients with and without dry eye/mouth. One patient with a positive finding at salivary gland sonography had a positive result of salivary gland biopsy. In the other four patients who received salivary gland biopsy, despite negative findings in salivary gland sonography, only one had a positive result of salivary gland biopsy. To be noted, scores evaluated by salivary gland sonography were negatively associated with levels of pain (rho = -0.360, = 0.023) and levels of sleep quality (rho = -0.447, = 0.004). Our pilot study demonstrated the potential of salivary gland biopsy in detecting undiagnosed pSS in primary FM patients.
原发性干燥综合征（pSS）常与纤维肌痛（FM）并存。唾液腺超声有助于pSS的诊断。我们旨在通过唾液腺超声在原发性FM患者中发现未确诊患者是否存在pSS。我们前瞻性招募了42例原发性FM患者。基于修订的纤维肌痛影响问卷（FIQR）评估FM症状。进行唾液腺超声检查。检查结果阳性的患者接受唾液腺活检。采用曼-惠特尼U检验和卡方检验进行比较。在原发性FM患者中，干眼患病率为83%，口干患病率为90%。有干眼/口干症状和无干眼/口干症状的患者唾液腺超声评分无差异。1例唾液腺超声检查结果阳性的患者唾液腺活检结果为阳性。在其他4例接受唾液腺活检的患者中，尽管唾液腺超声检查结果为阴性，但只有1例唾液腺活检结果为阳性。需要注意的是，唾液腺超声评估的评分与疼痛程度（rho = -0.360，P = 0.023）和睡眠质量水平（rho = -0.447，P = 0.004）呈负相关。我们的初步研究证明了唾液腺活检在检测原发性FM患者中未确诊的pSS方面的潜力。
