Sjogren`s Disease and Salivary Function Assessment
Patient 68 year old during 6 years carrying a seronegative rheumatoid arthritis with involvement of small and large joints. Treated with hydroxychloroquine and methotrexate. Now relatively well controlled, presents with dry eye and mouth.
Normal structural characteristics of
parotid and submandibular glands. Uptake and excretion of parotids is markedely
decreased with flattened curves. In the submaxillary glands it can be seen slow
uptake which progressive augmentation until the acid stimulation is given. The response
to stimulation is partial in the salivary glands with submandibular retention.
Thyroid not defined properly.Findings consistent with moderate to severe
function involvement of salivary glands especially in parotids. The late
retention in submaxillary with functional component may be explained by
association of an active inflammatory process. Marked decreased uptake in the
thyroid gland is related to old hypothyroidism currently treated by thyroid
hormone.
Bone scintigraphy,
showed increased uptake in both wrists several
small joints in hands, shoulders inflammatory process at L3, right sacroiliac joint, both knees and first
metatarsophalangeal joints and right tarsus.
Sjogren’s Syndrome is an autoinmune disease characterized by a chronic inflammatory process involving the salivary and lacrimal glands. The abnormalities are present in the parotid and at times more intensively in the submandibular glands.
According to Vinagre et al. an abnormal salivary gland scintigraphy result is accepted by the American-European consensus group as a criterion for the diagnosis of Sjögren's syndrome. Scintigraphic evaluation of salivary gland function also plays an important role in therapeutic decision and patient follow-up.
References:
1 Kazuya Shizukuishi. Scoring analysis of salivary gland scitigraphy in patients with Sjogren’s syndrome. Annals of Nuclear Medicine, vol 17, pages 627-631, 2003.
2
Vinagre F, Santos MJ, Prata A, da Silva JC, Santos AI.Assessment of salivary
gland function in Sjögren's syndrome: the role of salivary gland scintigraphy.
Autoimmun Rev. 2009 Jul;8(8):672-6.