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, 51 (2), 169-177

High Prevalence of Thyroid Disease and Role of Salivary Gland Scintigraphy in Patients With Xerostomia

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High Prevalence of Thyroid Disease and Role of Salivary Gland Scintigraphy in Patients With Xerostomia

Ji-Hoon Jung et al. Nucl Med Mol Imaging.

Abstract

Purpose: Although Sjögren's syndrome (SS) is the most common disease causing xerostomia, autoimmune thyroid diseases can also affect the salivary glands. The aim of our study was to estimate the prevalence of thyroid diseases (TD) in subjects with symptoms of xerostomia and evaluate the efficacy of salivary gland scintigraphy (SGS) in the detection of TD in patients with SS and without SS.

Methods: We retrospectively reviewed the SGS findings of 173 subjects (men:women, 29:144) with symptoms of xerostomia. Ejection fractions (EF) in the parotid and submandibular glands were calculated. Thyroid disease was diagnosed on the basis of the results of the visual assessment of tracer uptake in the thyroid gland on SGS images as well as serological thyroid function tests.

Results: Based on the American-European Criteria, 94 patients were diagnosed with SS. Hashimoto's thyroiditis was diagnosed in 63 patients, subacute thyroiditis in 23, subclinical hypothyroidism in five, and Graves' disease in one. There were significant differences in the EF values of the parotid and submandibular glands between patients with TD and those with undetermined diagnoses.

Conclusions: More than half of patients with xerostomia exhibited TD. Thyroid assessment by SGS is feasible, and SGS appears to be useful for the patients with xerostomia caused by TD. SGS may be the first imaging modality capable of evaluating both salivary gland function and thyroid gland status in patients with xerostomia. This strategy would make the requirement for additional workup for thyroid disease.

Keywords: Salivary gland scintigraphy; Sjögren’s syndrome; Thyroid disease; Xerostomia.

Conflict of interest statement

Conflict of Interest

Ji-hoon Jung, Chang-Hee Lee, Seung Hyun Son, Ju Hye Jeong, Shin Young Jeong, Sang-Woo Lee, Jaetae Lee, Byeong-Cheol Ahn declare that they have no conflict of interest.

Ethical Statement

The study protocol had been approved by the Ethics Committee of the Kyungpook National University Hospital (KNUH 2016-03-034-002). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments. No informed consent was needed, because of the retrospective design of our study.

Figures

Fig. 1
Fig. 1
Representative static images. Static images in the anterior (a) and the right and left lateral planes (b and c) obtained 20 min after tracer administration. Static images in the same planes (d, e, and f) acquired 10 min after sialagogue administration
Fig. 2
Fig. 2
Representative regions of interest. Ovoid regions of interest (ROIs) are drawn over the parotid and submandibular glands as well as the background (BG) on anterior static images obtained before (a) and after (b) sialagogue stimulation. The BG ROI is placed over the ipsilateral frontal region
Fig. 3
Fig. 3
Prevalence of thyroid diseases in relation to thyroid uptake
Fig. 4
Fig. 4
Prevalence of thyroid diseases in relation to thyroid uptake in patients with Sjögren’s syndrome
Fig. 5
Fig. 5
Prevalence of thyroid diseases in relation to thyroid uptake in patients without Sjögren’s syndrome
Fig. 6
Fig. 6
Box plot of ejection fraction of each subgroup. There are significant differences in the ejection fraction (EF) values of the right and left parotid (RP and LP) and submandibular (RS and LS) glands between patients with thyroid disease (TD) and those with an undetermined diagnosis (p < 0.05)

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