A comprehensive overview of major salivary gland ultrasonography in (suspected) primary Sjögren’s syndrome

Primary Sjögren’s syndrome is a chronic, systemic auto-immune disease characterized by inflammation of the lacrimal and salivary glands. This thesis demonstrates that major salivary gland ultrasonography is a promising non-invasive method to investigate salivary gland involvement in (suspected) Sjögren’s patients.
Major salivary gland ultrasonography is able to predict the outcome of a salivary gland biopsy at group level, but it cannot fully replace the biopsy for each individual patient. The combination of a positive ultrasound and the presence of anti-SSA antibodies (in blood) predicts very well if a patient will be classified with Sjögren’s syndrome.
For diagnostic purposes, it suffices to use a compact ultrasound scoring system, while for the division of classified Sjögren’s patients in subgroups, a more comprehensive scoring system is warranted.
With the addition of salivary gland ultrasonography to the classification criteria for Sjögren’s syndrome, the accuracy is comparable. However, the feasibility increases since clinicians are able to choose from a wider array of tests.
A detailed analyses was performed between three different methods that assess the involvement of the parotid gland, that is a biopsy, collection of saliva and ultrasonography. All three methods provide other (unique) information and are therefore complementary to each other.
Finally, the efficacy and safety of treatment with abatacept has been investigated.