The following is a summary of “Salivary ultrasonography and histopathologic evaluation of secondary Sjögren’s syndrome in rheumatoid arthritis patients,” published in the July 2023 issue of Rheumatology by Park et al.
Salivary ultrasonography (SGUS) and shear wave elastography (SWE) have been used to assess Sjögren’s syndrome (SS). However, their diagnostic performance and correlation with clinicopathological characteristics in secondary SS (sSS) are not well-established.
Researchers performed a retrospective study to explore the use of SGUS and SWE in investigating sSS in rheumatoid arthritis (RA) patients and examine its pathological correlations.
A total of 31 RA patients with sicca symptoms were evaluated for sSS and compared to 18 primary Sjögren’s syndrome (pSS) patients. The assessment involved SGUS, SWE, and conventional diagnostic methods, including minor salivary gland biopsy (MSGB). Using two different SGUS scoring systems (Hocevar and OMERACT), sSS was diagnosed in 19 out of 31 RA patients (61.2%) with sicca symptoms.
SGUS demonstrated good diagnostic performance (sensitivity: 68.4% and 78.9%; specificity: 91.7% and 75.0% for Hocevar and OMERACT, respectively) in distinguishing sSS from RA patients with simple sicca symptoms. MSGB revealed higher lymphoid infiltration areas in sSS and pSS patients than RA patients without SS. Focus score and lymphoid infiltration correlated with sonographic severity. Fibrosis severity in MSGB showed a stronger correlation with SWE than SGUS.
The study concluded that SGUS shows good diagnostic performance for sSS in RA patients, and SWE reflects histopathologic chronicity of MSGB well in both pSS and sSS.
