Ab0359 salivary ultrasonography and histopathologic evaluation of secondary sjögren’s syndrome in rheumatoid arthritis patients

Background Novel modalities, such as salivary ultrasonography (SGUS) and shear wave elastography (SWE), have previously been introduced to evaluate Sjögren’s syndrome (SS). However, in secondary SS (sSS), the diagnostic performance of SGUS and its relationship with clinicopathological characteristics have not yet been clearly defined. Objectives In this study, we aimed to investigate sSS in RA patients using SGUS and SWE and sought to determine its pathological correlations. Methods Thirty-one RA patients who presented with sicca symptoms were included to be evaluated on SS, and were compared with 18 primary SS (pSS) patients. All subjects were assessed through SGUS and SWE, as well as conventional diagnostic approaches for SS, including minor salivary gland biopsy (MSGB). In SGUS evaluation, two separate scoring systems, suggested by Hocevar and OMERACT, were used. Results Among 31 RA patients with sicca symptoms, 19 (61.2%) were diagnosed as sSS. RA patients with sSS showed significantly lower positivity for anti-Ro/La antibody than did pSS patients. Similar to pSS, SGUS showed good diagnostic performance in differentiating sSS from RA patients with simple sicca symptoms. The sSS and pSS patients exhibited significantly higher lymphoid infiltration areas in MSGB than RA patients without SS. Focus score and lymphoid infiltration areas correlated well with sonographic severity. The severity of fibrosis in MSGB showed better positive correlation with SWE than with SGUS. Conclusion sSS is frequent in RA patients and presents with less positivity for anti-Ro/La antibodies than does pSS. Similar to pSS, SGUS and SWE show good diagnostic performance for sSS, reflecting histopathologic severity well in MSGB. References [1] Jousse-Joulin S, Milic V, Jonsson MV et al. Is salivary gland ultrasonography a useful tool in Sjögren’s syndrome? A systematic review. Rheumatology (Oxford) 2016;55:789-800. [2] Mossel E, van Ginkel MS, Haacke EA et al. Histopathology, salivary flow and ultrasonography of the parotid gland: three complementary measurements in primary Sjögren’s syndrome. Rheumatology (Oxford) 2022;61:2472-82. [3] Arslan S, Durmaz MS, Erdogan H, Esmen SE, Turgut B, Iyisoy MS. Two-Dimensional Shear Wave Elastography in the Assessment of Salivary Gland Involvement in Primary Sjögren’s Syndrome. J Ultrasound Med 2020;39:949-56. Acknowledgements: NIL. Disclosure of Interests None Declared.