Characterizing hand and wrist ultrasound pattern in primary Sjogren's syndrome: a case-control study

Autor(es)

Guedes, L. K. N. ^[1] ; Leon, E. P. ^[1] ; Bocate, T. S. ^[1] ; Bonfigliolli, K. R. ^[1] ; Lourenco, V, S. ; Bonfa, E. ^[1] ; Pasoto, S. G. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Hosp Clin, Rheumatol Div, Fac Med, Av Dr Arnaldo 455, 3 Andar, Sala 3190, BR-01246903 Sao Paulo, SP - Brazil

• Tipo de documento: Artigo Científico
• Fonte: CLINICAL RHEUMATOLOGY; v. 39, n. 6 FEB 2020.
• Citações Web of Science: 0

Resumo

Introduction/objectives To evaluate the clinical relevance of high-resolution hand and wrist ultrasound (US) findings and their possible associations with anti-citrullinated peptide antibodies in primary Sjogren's syndrome (pSS). Methods Ninety-seven consecutive pSS patients (American-European Consensus Group, 2002) without meeting the American College of Rheumatology (ACR) criteria (1987) for rheumatoid arthritis (RA); 20 RA patients (ACR/European League Against Rheumatism (EULAR) criteria, 2010); and 80 healthy individuals with comparable age, gender, and ethnicity were enrolled in a case-control study. Disease activity was assessed by EULAR Sjogren's Syndrome Disease Activity Index (ESSDAI). US was performed by one expert blinded to anti-CCP, anti-MCV, and IgM rheumatoid factor tested by ELISA. Results Frequencies of grade 3 synovitis (9.3 vs. 0%, p = 0.004), tenosynovitis (36.1 vs. 3.8%, p < 0.001), and erosions (27.8 vs. 7.5%, p = 0.001) on US were higher in pSS patients than in healthy controls. ESSDAI presented a moderate correlation with the synovitis number (p = 0.001) and tenosynovitis (p < 0.001). Most pSS patients with erosions on US (81.5%) had negative anti-CCP. Nevertheless, anti-CCP >= 3x cut-off value was associated with the presence of erosions in pSS (p = 0.026). Erosions in pSS were mainly small size contrasting with moderate/large size in RA (p < 0.001), and positive power Doppler synovitis predominated in RA (p < 0.001). Conclusions US identified significant frequencies of grade 3 synovitis, tenosynovitis, and erosions in pSS. Synovitis and tenosynovitis numbers were correlated with ESSDAI. Association between erosions on US and anti-CCP (high titers) in pSS possibly identifies a subgroup with severe arthritis. These findings suggest that US is a useful method for assessing joint involvement in pSS. (AU)

• Processo FAPESP: 10/10013-4 - Autoanticorpos séricos da síndrome de Sjögren primária: estudo das associações clínicas e das possíveis correlações com anticorpos dirigidos a antígenos virais: vírus Epstein-Barr e Human T Leukemia virus 1
• Beneficiário: Sandra Gofinet Pasoto
• Modalidade de apoio: Auxílio à Pesquisa - Regular