Diagnostic value of salivary gland ultrasonography for secondary Sjogren syndrome in patients with systemic lupus erythematosus

Background Salivary gland ultrasound (SGUS) is a reliable technique for assessing the salivary glands in patients with primary Sjogren's syndrome (SS); however, the role of SGUS for diagnosis of secondary SS (sSS) in patients with systemic lupus erythematosus (SLE) was not examined. Objective To assess the diagnostic value of SGUS for sSS in patients with SLE, and to investigate the relationship between SGUS findings with clinical and laboratory characteristics of patients with SLE. Patients and methods This cross-sectional study included 49 patients with SLE. The diagnosis of sSS was confirmed according to the 2016 ACR/EULAR criteria. Salivary gland US was performed for all patients and graded using a validated Hocevar scoring system. A complete clinical and laboratory workup for SLE was assessed. Schirmer's test and the ocular staining were performed. Results Of the 49 patients with a mean age of 30.2 +/- 9.6 years, 98% were female. 19 (38.8%) had sSS. SGUS changes consistent with sSS (>= 17) were found in 29 (59.2%) of the patients. Patients with higher SGUS score had more sicca findings as well as positive anti-Ro, anti-La antibodies, and poorer psychological stress (p < 0.05). The SGUS (>= 17) showed a sensitivity of 84.2% and a specificity of 56.7% for sSS diagnosis, with an area under the curve of 0.77 (95% CI: 0.63, 0.91). Conclusion We propose salivary gland ultrasound as a non-invasive method in the diagnostic workup for sSS in patients with SLE. Further studies to confirm the diagnostic value of SGUS in a larger sample of patients with sSS will be necessary.

Automated summary

This study aimed to evaluate the diagnostic value of salivary gland ultrasound (SGUS) for secondary Sjogren's syndrome (sSS) in patients with systemic lupus erythematosus (SLE), and investigate the relationship between SGUS findings and clinical/laboratory characteristics of SLE patients. The results showed that SGUS had a high sensitivity but low specificity in diagnosing sSS. Patients with higher SGUS scores were more likely to have symptoms of sicca, positive anti-Ro and anti-La antibodies, and poorer psychological stress.