RT Journal Article
SR Electronic
T1 Clinical and Prognostic Significance of Parotid Scintigraphy in 405 Patients with Primary Sjögren’s Syndrome
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 585
OP 590
DO 10.3899/jrheum.090835
VO 37
IS 3
A1 MANUEL RAMOS-CASALS
A1 PILAR BRITO-ZERÓN
A1 MARTA PEREZ-DE-LIS
A1 CANDIDO DIAZ-LAGARES
A1 ALBERT BOVE
A1 MARIA-JOSE SOTO
A1 IRATXE JIMENEZ
A1 RAFAEL BELENGUER
A1 ANTONI SISO
A1 AFRICA MUXÍ
A1 FRANCESCA PONS
YR 2010
UL http://www.jrheum.org/content/37/3/585.abstract
AB Objective. To evaluate the association between the degree of involvement shown by parotid scintigraphy at diagnosis and the disease expression, outcomes, and prognosis of primary Sjögren’s syndrome (SS). Methods. All patients consecutively diagnosed with primary SS in our department between 1984 and 2008 were evaluated. The scintigraphic stages were classified into class 4 (severe involvement), class 2–3 (mild to moderate involvement), and class 1 (normal results). Results. A total of 405 patients with primary SS underwent parotid scintigraphy at diagnosis (47 had class 1 involvement, 314 had class 2–3, and 44 had class 4). Patients with class 4 had a higher frequency of parotid enlargement (p < 0.001), systemic involvement (p = 0.007), high titers of antinuclear antibody (p = 0.016), positive rheumatoid factor (p = 0.002), anti-Ro/SSA (p = 0.001), anti-La/SSB (p = 0.001), low C4 levels (p = 0.001), and low CH50 (p = 0.001) in comparison with the other 2 groups. A higher rate of lymphoma development was observed in patients with class 4 involvement. Adjusted multivariate Cox regression analysis showed a hazard ratio (HR) of 10.51 (p = 0.002) and Kaplan–Meier analysis a log-rank of 0.0005. Mortality was 5-fold higher in patients with class 4 involvement. Adjusted multivariate Cox regression analysis showed an HR of 5.33 (p = 0.001) and Kaplan-Meier analysis a log-rank of 0.033. Conclusion. Patients with SS presenting with severe scintigraphic involvement at diagnosis had a more pronounced autoimmune expression, a higher risk of developing systemic features and lymphoma, and a lower survival rate. Study of the degree of salivary gland dysfunction at diagnosis by parotid scintigraphy offers valuable clinical information on the prognosis and outcome of primary SS.