PMID- 37225928
OWN - NLM
STAT- MEDLINE
DCOM- 20230810
LR  - 20231011
IS  - 1434-9949 (Electronic)
IS  - 0770-3198 (Linking)
VI  - 42
IP  - 9
DP  - 2023 Sep
TI  - Ultrasonography in the diagnosis of suspected primary Sjogren's syndrome and 
      concordance with salivary gland biopsy: a Spanish single-center study.
PG  - 2409-2417
LID - 10.1007/s10067-023-06618-4 [doi]
AB  - OBJECTIVE: The study aims to evaluate the utility of major salivary gland 
      ultrasonography for diagnosis of primary Sjogren's syndrome (pSS) and to assess 
      its concordance with minor salivary gland biopsy (MSGB). METHODS: A 
      cross-sectional study of 72 patients with suspected pSS was performed. 
      Demographic, clinical, and serological data were collected. MSGB was performed, 
      as was ultrasonography. The ultrasound technician was blind to clinical, 
      serological, and histological data. The validity of ultrasonography compared with 
      MSGB, the American-European Consensus Group (AECG), and American College of 
      Rheumatology (ACR)/European Alliance of Associations for Rheumatology (EULAR) 
      criteria was assessed by calculating the percentage of agreement, sensitivity, 
      specificity, positive and negative predictive values, and area under the curve 
      (AUC). RESULTS: Based on MSGB as the gold standard, the percentage of agreement 
      between both tests was 78% (AUC 0.75). Based on the ACR/EULAR criteria, the 
      percentage of agreement was 83% (AUC 0.78) for ultrasonography and 81% (AUC 0.83) 
      for biopsy. Sensitivity and specificity were 90% and 67%, respectively, for 
      ultrasonography and 76% and 90% for biopsy. The results were similar with the 
      AECG criteria. The intra- and inter-observer variability was good (kappa > 0.7). 
      Significant differences were observed for positive anti-Ro52 values and 
      hypergammaglobulinemia in pathological ultrasound scans. CONCLUSION: Diagnostic 
      ultrasonography is as useful as MSGB in pSS. Therefore, it could be included in 
      the classification criteria. In this cohort, it proved more sensitive than MSGB 
      and could be used as an initial test for patients suspected of having pSS. MSGB 
      could be used in cases where clinical and serological results are inconclusive. 
      Key Points * Major salivary gland ultrasonography adds diagnostic value similar 
      to that of MSGB, thus potentially enabling this invasive procedure to be avoided. 
      * Ultrasonography could be included in the classification criteria for primary 
      Sjogren's syndrome. * Given that ultrasonography is more sensitive and less 
      specific than MSGB, it could be used as an initial diagnostic test in patients 
      with suspected Sjogren's syndrome. * Biopsy should be performed in those cases 
      where ultrasonography, clinical, and serological data are inconclusive.
CI  - (c) 2023. The Author(s), under exclusive licence to International League of 
      Associations for Rheumatology (ILAR).
FAU - Barrio-Nogal, Laura
AU  - Barrio-Nogal L
AUID- ORCID: 0000-0002-2429-407X
AD  - Rheumatology Department, Hospital Universitario de Torrejon, Madrid, Spain. 
      labano_1990@hotmail.com.
FAU - Novella-Navarro, Marta
AU  - Novella-Navarro M
AUID- ORCID: 0000-0002-2200-0859
AD  - Rheumatology Department, Hospital Universitario de La Paz, Madrid, Spain.
FAU - Heras, Cristina Bohorquez
AU  - Heras CB
AD  - Rheumatology Department, Hospital Universitario Principe de Asturias, Madrid, 
      Spain.
FAU - Sala-Icardo, Luis
AU  - Sala-Icardo L
AUID- ORCID: 0000-0002-5738-7133
AD  - Rheumatology Department, Hospital Universitario de Torrejon, Madrid, Spain.
FAU - Calvo-Aranda, Enrique
AU  - Calvo-Aranda E
AUID- ORCID: 0000-0002-3095-0969
AD  - Rheumatology Department, Hospital Universitario Infanta Leonor, Madrid, Spain.
FAU - Gomez, Ana Perez
AU  - Gomez AP
AD  - Rheumatology Department, Hospital Universitario Principe de Asturias, Madrid, 
      Spain.
LA  - eng
PT  - Journal Article
DEP - 20230525
PL  - Germany
TA  - Clin Rheumatol
JT  - Clinical rheumatology
JID - 8211469
RN  - 89022-11-7 (2'-carbomethoxyphenyl 4-guanidinobenzoate)
SB  - IM
MH  - Humans
MH  - *Sjogren's Syndrome/diagnostic imaging/pathology
MH  - Cross-Sectional Studies
MH  - Salivary Glands/diagnostic imaging/pathology
MH  - Ultrasonography/methods
MH  - Biopsy
OTO - NOTNLM
OT  - Diagnosis
OT  - Minor salivary gland biopsy
OT  - Sjogren syndrome
OT  - Ultrasonography
EDAT- 2023/05/25 01:07
MHDA- 2023/08/10 06:42
CRDT- 2023/05/24 23:29
PHST- 2023/02/20 00:00 [received]
PHST- 2023/04/28 00:00 [accepted]
PHST- 2023/04/26 00:00 [revised]
PHST- 2023/08/10 06:42 [medline]
PHST- 2023/05/25 01:07 [pubmed]
PHST- 2023/05/24 23:29 [entrez]
AID - 10.1007/s10067-023-06618-4 [pii]
AID - 10.1007/s10067-023-06618-4 [doi]
PST - ppublish
SO  - Clin Rheumatol. 2023 Sep;42(9):2409-2417. doi: 10.1007/s10067-023-06618-4. Epub 
      2023 May 25.