Sonographic evaluation of salivary glands in juvenile Sjögren's syndrome
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Vanessa Ramos Guissa1, Evelyne Lopes Martinelli1, Letícia Maria Kolachinski Raposo Brandão1
1Pontíficia Universidade Católica de Campinas.
Insights
Ultrasonography of salivary glands aids in diagnosing juvenile Sjögren's syndrome, a rare autoimmune condition. This imaging technique is crucial for identifying characteristic patterns in children with recurrent parotitis and positive autoantibodies.
Area of Science:
- Pediatric Rheumatology
- Autoimmune Diseases
- Diagnostic Imaging
Background:
- Juvenile Sjögren's syndrome is an underdiagnosed autoimmune condition in children.
- Recurrent parotitis, xerophthalmia, and xerostomia are key symptoms.
- Autoantibodies like anti-SSA/Ro and anti-SSB/La are often present.
Observation:
- Two pediatric cases of Sjögren's syndrome are presented.
- Ultrasonography revealed characteristic salivary gland patterns (Grade 4 B-mode).
- Spectral Doppler showed intense Power Doppler signal and reduced vascular resistance.
Findings:
- Salivary gland ultrasound findings were consistent with juvenile Sjögren's syndrome in both cases.
- Ultrasound demonstrated chronic and active inflammation in the salivary glands.
- The imaging findings supported the clinical and immunological diagnosis.
Implications:
- Salivary gland ultrasonography is a valuable diagnostic tool for juvenile Sjögren's syndrome.
- Early diagnosis can lead to timely management and improved outcomes.
- Highlights the importance of imaging in pediatric autoimmune diseases.
Abstract:
IIntroduction: Sjögren's syndrome in childhood is a rare autoimmune disease and mostly under-diagnosed. The aim of this study is to highlight the importance of ultrasonographic assessment of the salivary glands in children with recurrent parotitis and positive autoantibodies. Two cases of ultrasonographic patterns typical of Sjögren's syndrome have been described below. Case 1: Female, 7 years old, reporting for 2 years recurrent parotitis, xerophthalmia, xerostomia, polyarthralgia and fever. Immunological tests were positive for antinuclear antibodies, rheumatoid factor, anti-SSA/Ro and anti-SSB/La. Salivary glands ultrasound was consistent with Grade 4 by the B-mode method and the spectral Doppler with presence of intense Power Doppler signal and decreased vessels internal resistance, supporting the diagnosis of juvenile Sjögren's syndrome. Case 2: Female, 10 years old, reporting recurrent parotitis for 1 year and polyarthritis for 10 days. The supplementary tests revealed positive antibodies for Sjögren's syndrome. Salivary glands Ultrasound and Spectral Doppler were consistent with chronic and active inflammatory process of the salivary glands in the juvenile Sjögren's syndrome.
Discussion:
Salivary glands ultrasound can be a useful exam in the diagnosis of juvenile Sjögren's syndrome.