Combined classification system based on ACR/EULAR and ultrasonographic scores for improving the diagnosis of Sjögren's syndrome.
Yukinori Takagi,Hideki Nakamura,Misa Sumi,Toshimasa Shimizu,Yasuko Hirai,Yoshiro Horai,Ayuko Takatani,Atsushi Kawakami,Sato Eida,Miho Sasaki,Takashi Nakamura +10 more
TL;DR: The diagnostic accuracy of various combinations of the ACR/EULAR and US classifications for diagnosing SS is compared, using the clinical diagnosis of SS by rheumatologists as the gold standard.
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Abstract: We retrospectively evaluated the effectiveness of combined use of salivary gland ultrasonography (US) and the 2016 American College of Rheumatology/European League Against Rheumatic Disease (ACR/EULAR) classification criteria for improving the diagnostic efficiency in patients with Sjogren's syndrome (SS). A US-based salivary gland disease grading system was developed using a cohort comprising 213 SS or non-SS patients who fulfilled the minimum requirements for classifying SS based on the American-European Consensus Group (AECG) and ACR criteria. Using 62 SS or non-SS patients from the 213 patients and who had also undergone all the 5 examinations needed for the ACR/EULAR classification, we compared the diagnostic accuracy of various combinations of the ACR/EULAR and US classifications for diagnosing SS, using the clinical diagnosis of SS by rheumatologists as the gold standard. The ACR/EULAR criteria discriminated clinical SS patients with 77% and 79% accuracy for those with primary or secondary SS and for those with primary SS, respectively. However, the integrated score system of the ACR/EULAR and US classifications yielded 92% and 93% accuracy for these 2 SS patient groups, respectively, provided that US score of 3 was assigned to patients with US grade ≥2, and then patients with integrated threshold score of ≥5 were diagnosed as SS. Cross-validation also indicated improved accuracy of the integrated ACR/EULAR and US score system (91.9 and 93.0% for primary/secondary and primary SS patients, respectively) over that by the ACR/EULAR criteria alone. (74.2 and 86.0%, respectively). The integrated ACR/EULAR and US scoring system can improve the diagnosis of patients with clinical SS.
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Incorporation of Salivary Gland Ultrasonography Into the American College of Rheumatology/European League Against Rheumatism Criteria for Primary Sjögren's Syndrome
Jolien F van Nimwegen,Esther Mossel,Konstantina Delli,Martha S van Ginkel,Alja J Stel,Frans G. M. Kroese,Fred K L Spijkervet,Arjan Vissink,Suzanne Arends,Hendrika Bootsma +9 more
TL;DR: To assess whether the addition of salivary gland ultrasonography (SGUS) or replacement of current criteria items by SGUS influences the performance of the American College of Rheumatology/European League Against Rheumatism (EULAR) criteria for primary Sjögren's syndrome, a meta-analysis is conducted.
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Imaging in Primary Sjogren's Syndrome
Martha S van Ginkel,Andor W. J. M. Glaudemans,Bert van der Vegt,Esther Mossel,Frans G. M. Kroese,Hendrika Bootsma,Arjan Vissink +6 more
TL;DR: Describing imaging techniques used in primary Sjögren’s syndrome with a focus on the salivary glands and their contribution to diagnosing and staging of pSS-associated lymphomas reveals their potential in assessing disease activity and disease progression.
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Disease activity and damage in patients with primary Sjogren's syndrome: Prognostic value of salivary gland ultrasonography.
TL;DR: Pathological salivary gland ultrasonography is associated with high disease activity and damage in patients with primary Sjogren’s syndrome, and sUS abnormalities might be surrogate items for glandular domains in the assessment of diseaseactivity and damage.
Juvenile primary Sjögren's syndrome with ranula: is ranula a clinical sign that leads to early detection of Sjögren's syndrome?
TL;DR: It is thought that ranula is a sign of early-stage SS, and patients with ranulae should undergo careful assessment of not only the sublingual glands but also the parotid and submandibular glands with MRI and/or US to investigate possible SS.
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