Diagnostic value of salivary gland ultrasonography for Sjӧgren's syndrome in patients with sicca symptoms

Abstract

Aim of the workTo assess the diagnostic value of salivary gland ultrasonography (SGUS) for Sjӧgren's syndrome (SS) and to compare it with minor salivary gland biopsy (MSGB) in patients with sicca symptoms. Patients and methodsThirty patients with suspected SS (sicca symptoms only) were included in the study. The diagnosis of SS was confirmed according to the 2012 American College of Rheumatology criteria. SGUS was performed for all patients and the bilateral echostructure of the parotid and submandibular glands were graded from 0 to 3. SGUS score ≥2 was considered abnormal. A complete work up for SS was performed in all patients including a standardized clinical examination performed by the same rheumatologist, serological and laboratory tests, ocular tests and MSGB. Schirmer’s test and the Ocular Staining Score (OSS) using rose Bengal were performed. ResultsOf the 30 patients, 10 had primary sicca symptoms (mean age 42.3±13.1years) and 20 secondary (49.5±8.6years) and most were females. The frequency of SS syndrome by ACR criteria was 6.7%. By adding ultrasound item to ACR criteria (SGUS score ≥2) the frequency of SS syndrome increased to 10%. The SGUS (cutoff score ≥2) showed a sensitivity of 66.6% and a specificity of 85.2% for SS diagnosis. Histopathology of MSGB showed no significant correlation with SGUS scores and remained the most diagnostic method for SS that had sensitivity and specificity of 100%. ConclusionSGUS is a noninvasive method with high diagnostic value for diagnosis of primary and secondary SS.