Advanced

Primary Sjögren's syndrome: The diagnostic and prognostic value of salivary gland ultrasonography using a simplified scoring system.

Theander, Elke LU and Mandl, Thomas LU (2014) In Arthritis Care and Research1988-01-01+01:002000-01-01+01:00 66(7). p.1102-1107
Abstract
Objective: To determine the usefulness and prognostic value of a simplified salivary gland ultrasonography (SGUS) scoring system in primary Sjögren's syndrome (pSS). Methods: Patients with pSS (n=105) and controls (n=57) were evaluated using a simplified SGUS scoring system. Parenchymal homogeneity in salivary glands was graded from 0 to 3, grades 0 (normal) and 1 (mild inhomogeneity) being interpreted as normal or unspecific, and grades 2 (several rounded) and 3 (numerous or confluent hypoechoic lesions) as pSS-typical. Associations between SGUS and clinical, histological and laboratory disease characteristics were analyzed. Results: The characteristic hypoechoic lesions (score 2 or 3) were found in 52% of pSS patients and in 1 (1.8%) of... (More)
Objective: To determine the usefulness and prognostic value of a simplified salivary gland ultrasonography (SGUS) scoring system in primary Sjögren's syndrome (pSS). Methods: Patients with pSS (n=105) and controls (n=57) were evaluated using a simplified SGUS scoring system. Parenchymal homogeneity in salivary glands was graded from 0 to 3, grades 0 (normal) and 1 (mild inhomogeneity) being interpreted as normal or unspecific, and grades 2 (several rounded) and 3 (numerous or confluent hypoechoic lesions) as pSS-typical. Associations between SGUS and clinical, histological and laboratory disease characteristics were analyzed. Results: The characteristic hypoechoic lesions (score 2 or 3) were found in 52% of pSS patients and in 1 (1.8%) of controls, p<0.001. Specificity and positive predictive value of abnormal SGUS for pSS were both 98%, sensitivity and negative predictive value were 52 and 53%. Age or disease duration did not influence the SGUS result. Dryness did not differ between normal or abnormal SGUS. However, patients with pathological SGUS had significantly more often signs and symptoms of systemic complications, higher disease activity and more frequently markers of lymphoma development, such as salivary gland swelling, skin vasculitis, germinal center-like structures in salivary gland biopsy and CD4(+) T-lymphocytopenia. Conclusion: SGUS using a simplified score for assessment of parenchyma dyshomogeneity is highly specific for pSS and offers the advantage of identifying patients with severe disease or at lymphoma risk. Early disease may however be missed. It is easy and rapidly performed and may be considered as an item in future modified classification criteria. © 2013 American College of Rheumatology. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Arthritis Care and Research1988-01-01+01:002000-01-01+01:00
volume
66
issue
7
pages
1102 - 1107
publisher
John Wiley & Sons
external identifiers
  • pmid:24339361
  • wos:000337976700017
  • scopus:84903462319
ISSN
2151-4658
DOI
10.1002/acr.22264
language
English
LU publication?
yes
id
672ba8ff-5c77-4ae0-affd-caa449ae0e13 (old id 4223675)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24339361?dopt=Abstract
date added to LUP
2014-01-04 18:23:40
date last changed
2017-10-22 03:09:19
@article{672ba8ff-5c77-4ae0-affd-caa449ae0e13,
  abstract     = {Objective: To determine the usefulness and prognostic value of a simplified salivary gland ultrasonography (SGUS) scoring system in primary Sjögren's syndrome (pSS). Methods: Patients with pSS (n=105) and controls (n=57) were evaluated using a simplified SGUS scoring system. Parenchymal homogeneity in salivary glands was graded from 0 to 3, grades 0 (normal) and 1 (mild inhomogeneity) being interpreted as normal or unspecific, and grades 2 (several rounded) and 3 (numerous or confluent hypoechoic lesions) as pSS-typical. Associations between SGUS and clinical, histological and laboratory disease characteristics were analyzed. Results: The characteristic hypoechoic lesions (score 2 or 3) were found in 52% of pSS patients and in 1 (1.8%) of controls, p&lt;0.001. Specificity and positive predictive value of abnormal SGUS for pSS were both 98%, sensitivity and negative predictive value were 52 and 53%. Age or disease duration did not influence the SGUS result. Dryness did not differ between normal or abnormal SGUS. However, patients with pathological SGUS had significantly more often signs and symptoms of systemic complications, higher disease activity and more frequently markers of lymphoma development, such as salivary gland swelling, skin vasculitis, germinal center-like structures in salivary gland biopsy and CD4(+) T-lymphocytopenia. Conclusion: SGUS using a simplified score for assessment of parenchyma dyshomogeneity is highly specific for pSS and offers the advantage of identifying patients with severe disease or at lymphoma risk. Early disease may however be missed. It is easy and rapidly performed and may be considered as an item in future modified classification criteria. © 2013 American College of Rheumatology.},
  author       = {Theander, Elke and Mandl, Thomas},
  issn         = {2151-4658},
  language     = {eng},
  number       = {7},
  pages        = {1102--1107},
  publisher    = {John Wiley & Sons},
  series       = {Arthritis Care and Research1988-01-01+01:002000-01-01+01:00},
  title        = {Primary Sjögren's syndrome: The diagnostic and prognostic value of salivary gland ultrasonography using a simplified scoring system.},
  url          = {http://dx.doi.org/10.1002/acr.22264},
  volume       = {66},
  year         = {2014},
}