Journal of Peking University(Health Sciences) >
Application of ultrasonography scoring system in the assessment of IgG4-related sialadenitis
Received date: 2019-08-26
Online published: 2019-12-19
Supported by
Supported by National Key R&D Program of China(2017YFA0105802);Peking University People’s Hospital Research and Development Funds(RDH 2017-02)
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
Xiao-ran NING , Zi-qiao WANG , Shan-shan ZHANG , Xia ZHANG , Su-mei TANG , Yan-ying LIU . Application of ultrasonography scoring system in the assessment of IgG4-related sialadenitis[J]. Journal of Peking University(Health Sciences), 2019 , 51(6) : 1032 -1035 . DOI: 10.19723/j.issn.1671-167X.2019.06.009
| [1] | Yamamoto M, Takahashi H, Shinomura Y . Mechanisms and assessment of IgG4-related disease: Lessons for the rheumatologist[J]. Nat Rev Rheumatol, 2013,10(3):148-159. |
| [2] | Vivino FB . Sj?gren’s syndrome: Clinical aspects[J]. Clin Immunol, 2017,9(182):48-54. |
| [3] | Umehara H, Okazaki K, Masaki Y , et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011[J]. Mod Rheumatol, 2012,22(1):21-30. |
| [4] | Shiboski SC, Shiboski CH, Criswell L , et al. American College of Rheumatology classification criteria for Sj?gren’s syndrome: a data-driven, expert consensus approach in the Sjogren’s International Collaborative Clinical Alliance cohort[J]. Arthritis Care Res, 2012,64(4):475-487. |
| [5] | Cornec D, Jousse-Joulin S, Pers JO , et al. Contribution of sali-vary gland ultrasonography to the diagnosis of Sj?gren’s syndrome: toward new diagnostic criteria?[J]. Arthritis Rheum, 2013,65(1):216-225. |
| [6] | Hocevar A, Ambrozic A, Rozman B , et al. Ultrasonographic changes of major salivary glands in primary Sj?gren’s syndrome. Diagnostic value of a novel scoring system[J]. Rheumatol, 2005,63(3):379-383. |
| [7] | Satomi A, Kenji O, Naoya N , et al. Sonographic appearance of the submandibular glands in patients with immunoglobulin G4-related disease[J]. J Ultrasound Med, 2012,31(3):489-493. |
| [8] | Narayan AK, Baer A, Fradin J . Sonographic findings of IgG4-related disease of the salivary glands: Case report and review of the literature[J]. J Clin Ultrasound, 2018,46(1):73-77. |
| [9] | Omotehara S, Nishida M, Satoh M , et al. Sonographic findings of immunoglobulin G4-related sclerosing sialadenitis[J]. J Med Ultrason, 2016,43(2):257-262. |
| [10] | Li W, Xie XY, Su JZ , et al. Ultrasonographic features of immunoglobulin G4-related sialadenitis[J]. Ultrasound Med Biol, 2016,42(1):167-175. |
| [11] | Shimizu M, Okamura K, Kise Y , et al. Effectiveness of imaging modalities for screening IgG4-related dacryoadenitis and sialadenitis (Mikulicz’s disease) and for differentiating it from Sj?gren’s syndrome (SS), with an emphasis on sonography[J]. Arthritis Res Ther, 2015,17(1):223-234. |
| [12] | Zhang X, Zhang S, He J , et al. Ultrasonographic evaluation of major salivary glands in primary Sj?gren’s syndrome: comparison of two scoring systems[J]. Rheumatol, 2015,54(9):1680-1687. |
| [13] | Tang J, Cai S, Ye C , et al. Biomarkers in IgG4-related disease: A systematic review [J/OL]. Semin Arthritis Rheum, ( 2019 -06-28). doi: 201910.1016/j.semarthrit.2019.06.018. |
/
| 〈 |
|
〉 |