Ecografía de las glándulas salivares en el síndrome de Sjögren primario

Abstract

Primary Sjögren´s syndrome (pSS) is a systemic autoimmune disease characterized by mouth and eyes dryness (xerostomía and xerophtalmia)1. Classification criteria of pSS includes subjective and objective dryness of mouth and eyes, and also objective autoimmune involvement2-4. T-cell infiltration of exocrine glands confirmed by minor salivary gland biopsy (MSG) and/or positive autoautoimmunity are mandatory to classified a patient as having pSS in the last published classification criteria3,4. Salivary gland ultrasound (SGU) has demonstrated to be useful and reliable to assess major salivary glands5, 6. Further, SGU seems to be as sensitive as sialography and salivary gland scintigraphy7, but more specific in the assessment of SG in pSS8. Moreover, SGU has been proposed to be included in the classification criteria for pSS9 additional to or instead of sialography and SG scintigraphy 10. Some authors suggested a relation between a pathological SGU and a positive MSG biopsy11, and other authors proposed to exchange salivary gland biopsy with SGU, but this change means a significant reduction in sensitivity, from 77.9% to 68.8%12. Even more interesting than it´s high specificity and it´s diagnosing usefulness is that SGU could be associated with more extra-glandular involvement and higher risk of lymphoma13. Some studies also have associated pSS findings in SGU with positive autoantibodies such as anti-SSA/SSB antibodies, rheumatoid factor (RF) and antinuclear antibodies (ANA)13-17. The main objective of our study is to describe the relation between pSS SGU findings with clinical data, extra-glandular involvement and immunological data in our pSS cohort...