University of Groningen Primary Sjögren’s Syndrome
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University of Groningen Primary Sjögren’s Syndrome Delli, Konstantina IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2017
Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Delli, K. (2017). Primary Sjögren’s Syndrome: towards a new era in diagnosis, treatment and e-patient education [Groningen]: University of Groningen
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Download date: 22-12-2017
Primary Sjögren’s Syndrome: Towards a new era
In diagnosis, treatment and e-patient education
PhD thesis
to obtain the degree of PhD at the University of Groningen on the authority of the Rector Magnificus Prof. E. Sterken and in accordance with the decision by the College of Deans.
This thesis will be defended in public on Wednesday 31st May at 14:30 hours
by
Konstantina Delli born on 23 May 1980 in Chania, Greece The research presented in this thesis was performed and financed at the Depart- ment of Oral and Maxillofacial Surgery, University Medical Center Groningen, The Netherlands. © Konstantina Delli All rights reserved. No parts of this publication may be transmitted, in any form or by any means, without permission of the author. Icon made by Freepik from www.flaticon.com Bookdesign: Sgaar Groningen Printed by: Drukkerij van der Eems Heerenveen ISBN: 978-90-367-9789-4 | E-book: 978-90-367-9788-7
Supervisors Prof. F.K.L. Spijkervet Prof. A. Vissink Prof. H. Bootsma
Assessment Committee Prof. R.A.J.O. Dierckx Prof. F. van den Hoogen Prof. R. Jonsson Paranimfen Drs E. Mossel Drs J.F. van Nimwegen
Contents Chapter 1 Introduction 9 Chapter 2 Xerostomia 19 Chapter 3 Diagnosis 47 A. Diagnostic properties of ultrasound of major salivary glands in Sjögren’s syndrome: a meta-analysis 49 B.
ultrasonography in Sjögren’s syndrome patients: a meta-analysis.’ by Song and Lee (2014) 75 C.
in patients with clinically suspected primary Sjögren’s syndrome 81 D. Ultrasonography of major salivary glands compared to parotid and labial gland biopsy and classification criteria in patients with clinically suspected primary Sjögren’s syndrome 95 E. Can ultrasound of the major salivary glands differentiate primary Sjögren’s syndrome from other systemic diseases with salivary gland involvement? 119
F. Salivary gland biopsy for Sjögren’s Syndrome 133 Chapter 4 Treatment 151
A. Towards personalised treatment in primary Sjögren’s syndrome: baseline parotid histopathology predicts responsiveness to rituximab treatment 153
B. In primary Sjögren’s syndrome high absolute numbers and proportions of B cells in parotid glands predict responsiveness to rituximab as defined by ESSDAI, but not by SSRI 173 C.
germinal centres and other histopathological parameters in salivary gland tissue of patients with primary Sjögren’s syndrome 181 Chapter 5 e-Patient education 187
A. Internet information on xerostomia: what should patients expect? 189 B.
205 Chapter 6 General discussion 219
Chapter 7 Summary
231 Chapter 8 Samenvatting 237
Acknowledgements 245
Curriculum vitae & Publications 251
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