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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (6): 1032-1035. doi: 10.19723/j.issn.1671-167X.2019.06.009

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Application of ultrasonography scoring system in the assessment of IgG4-related sialadenitis

Xiao-ran NING1,2,Zi-qiao WANG1,Shan-shan ZHANG3,Xia ZHANG1,Su-mei TANG1,Yan-ying LIU1,△()   

  1. 1. Department of Rheumatology & Immunology, Peking University People’s Hospital, Beijing 100044, China
    2. Department of Rheumatology & Immunology, People’s Hospital of Hebei Province, Shijiazhuang 050051, China
    3. Department of Ultrasound, Peking University People’s Hospital, Beijing 100044, China
  • Received:2019-08-26 Online:2019-12-18 Published:2019-12-19
  • Contact: Yan-ying LIU E-mail:liuyanying20030801@msn.com
  • Supported by:
    Supported by National Key R&D Program of China(2017YFA0105802);Peking University People’s Hospital Research and Development Funds(RDH 2017-02)

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Abstract:

Objective: To assess the diagnostic value of salivary gland ultrasonography (SGUS) for IgG4-related sialadenitis.Methods: Ultrasonography examination of major salivary glands was conducted for 48 IgG4-related sialadenitis patients and 50 Sj?gren’s syndrome patients, whose ages and disease duration were matched. The imaging features were graded using two different scoring systems (0-16 and 0-48, respectively) obtained from the grades of bilateral parotid and submandibular glands. The scores were used to further evaluate the features of salivary gland ultrasonography in IgG4-related sialadenitis and to compare them with Sj?gren’s syndrome patients. The association of SGUS scores of IgG4-related sialadenitis group with serological tests was analyzed.Results: The mean age of IgG4-related sialadenitis group and Sj?gren’s syndrome group was 49.23 years and 50.44 years, respectively. The serum IgG4 level of the patients in the IgG4-related sialadenitis group was increased, with an average (9.60±6.43) g/L. And the serum IgE level was at a median of 251.5 (123.4-543.6) IU/mL. In the 0-16 system, the scores of submandibular glands of the patients in IgG4-related sialadenitis and Sj?gren’s syndrome were 6.0 (6.0-8.0) and 4.0 (2.0-8.0), and the scores of the total four glands were 10.0 (8.0-14.0) and 8.0 (4.0-12.0) respectively. In the 0-48 system, the scores of submandibular glands with IgG4-related sialadenitis and Sj?gren’s syndrome were 18.0 (14.5-20.0) and 11.0 (7.0-14.0), and the scores of the total four glands were 26.0 (18.5-34.0) and 21.5 (15.0-26.3) respectively. It suggested that in the 0-16 system and the 0-48 system, scores of submandibular glands and the total of four glands of IgG4-related sialadenitis were higher than those of Sj?gren’s syndrome. Meanwhile, the association analysis of 0-48 system showed a positive correlation of SGUS scores with serum IgG4, which also showed a positive correlation of SGUS scores with serum IgE in 0-16 system.Conclusion: Semi-quantitative ultrasonography scoring systems can evaluate and quantify the lesions of salivary glands, which can be helpful in the diagnosis and differential diagnosis of IgG4-related sialadenitis combined with the clinical manifestations, serological indicators and/or histopathological manifestations. Ultrasonography can also assess the activity of IgG4-related sialadenitis preliminarily.

Key words: Sialadenitis, Immunoglobulin G, Sj?gren’s syndrome, Ultrasonography, Diagnosis, differential

CLC Number: 

  • R781.72

Figure 1

Distribution of the salivary gland ultrasonography scores using 0-16 scoring system for IgG4-RS and SS IgG4-RS, IgG4-related sialadenitis; SS, Sj?gren’s syndrome. Values are shown with median and quartile. A, scores of parotid glands; B, scores of submandibular glands; C, scores of total of four glands. *P<0.05, by Mann-Whitney test."

Figure 2

Distribution of the salivary gland ultrasonography scores using 0-48 scoring system for IgG4-RS and SS IgG4-RS, IgG4-related sialadenitis; SS, Sj?gren’s syndrome. Values are shown with median and quartile. A, scores of parotid glands; B, scores of submandibular glands; C, scores of total of four glands. *P < 0.05, by Mann-Whitney test."

Figure 3

Association of salivary gland ultrasonography scores of IgG4-RS group with serological tests A, scores of total of four glands (0-48) with the level of serum IgG4; B, scores of total of four glands (0-16) with the level of serum IgE."

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