Abstract

Objectives: To investigate the use of ultrasonic to assess the salivary glands in RA patients presenting with sicca symptoms, and its correlations with clinical, laboratory and minor salivary gland biopsy. Methods: One hundred and fifty RA patients classified into two equal subgroups according to the presence of sicca symptoms, in addition to seventy five healthy controls. All patients were subjected to self-reported questionnaire about sicca symptoms, DAS 28, Unstimulated whole salivary flow rate (UWSFR), Schirmer's test, ESR, CRP, RF, Anti- CCP, Anti-Ro, Anti-La antibodies, serum and salivary CXC ligand 13 (CXCL13), B cell activating factor (BAFF), ultrasonography for major salivary gland and biopsy of minor salivary gland. Results: 93.3% of RA patients with sicca symptoms and 9.3% of RA patients without sicca symptoms revealed significant pathological changes in salivary ultrasonography. The sensitivity of ultrasonography in early detection of secondary Sjogren's syndrome in RA patients was 93.3% and the specificity was 90.67%. There were significant association ultrasonography changes with serum and salivary levels of CXCL13 and BAFF (p < 0.001). Salivary glands ultrasonography is negatively correlated with UWSFR and positively correlated with salivary levels of CXCL13 and BAFF (p < 0.001- p < 0.05) and salivary gland biopsy (p < 0.001). Conclusions: Submandibular ultrasonography is a promising practical technique that can be used for detection of pathological changes in secondary Sjogren's syndrome in RA.

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