SAT0587 Major salivary glands ultrasonography in differential diagnosis of igg4-related disease and primary sjogren’s syndrome

Background IgG4-related disease (IgG4-RD) is a group of fibro-inflammatory immunomediated conditions with IgG4 overexpression in the serum and affected tissues in the majority of patients. Major salivary and lacrimal glands are the most frequently affected sites in IgG-RD. Moderate sicca symptoms can be present as well thus requiring differential diagnosis with primary Sjogren’s syndrome (pSS). Major salivary glands ultrasonography (sUS) has been reported as an effective diagnostic tool in pSS. Objectives To evaluate the difference in sUS score in pSS and IgG4-RD patients Methods 15 patients with IgG4-related sialoadenitis consecutively admitted to our clinic and 28 with pSS underwent sUS. Parenchymal echogenicity, homogeneity, hypoechogenic and hyperechogenic areas and clearness of salivary gland border were scored according to the Hocevar scoring system (cut-off – 15 points). Statistical analyses were performed using MEDCALC program. Median values of the sUS score and Mann-Whitney U-test were used to evaluate differences in total ultrasound score between patients in two groups. Results All patents with IgG4-related sialadenitis and pSS had some sUS abnormalities. The most frequent feature in IgG4-RD were: the presence of hypoechotic lesions in major salivary glands (53% of patients) or diffuse salivary gland parenchyma hypoechogenity (27% of patients) and multiple intraglandular lymph nodes (66,7% of patients). Median value of sUS score in IgG4-RD group was 12 points and in pSS group – 22 points. The difference was significant (Mann-Whitney U-test 60.5, p Conclusions Although different US-changes are frequently seen in IgG4-RD patients, sUS Hocevar score seems to be a rather reliable tool to differentiate IgG 4-related sialoadenitis and pSS. Disclosure of Interest None declared