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Objectives Exocrine gland involvement, typically presenting as sicca symptoms, is associated with Sjögren’s Disease (SjD).1 Nevertheless, salivary gland abnormalities may also occur in Systemic Lupus Erythematosus (SLE) patients, associated with anti-SSA and/or anti-SSB antibodies.2-5 Salivary Gland Ultrasonography (SGUS) may identify glandular involvement in SjD with a high specificity, but in SLE, the evidence remains limited.6Our goal was to evaluate SGUS findings in anti-SSA and/or anti-SSB–positive SLE patients and to assess their association with sicca symptoms and disease characteristicsMethods We conducted a cross-sectional study including consecutive patients followed at the Coimbra’s Rheumatology Department Lupus Clinic who fulfilled the 2019 EULAR/ACR SLE classification criteria and tested positive for anti-SSA and/or anti-SSB antibodies. All participants underwent bilateral SGUS of the parotid and submandibular glands, scored 0–3 per gland according to OMERACT definitions.7 SGUS positivity was defined as at least one gland with a score of 2 or higher. Sicca symptoms (ocular and oral dryness) were recorded using a standardized questionnaire. Continuous variables were expressed as mean ± standard deviation (SD) or median [interquartile range (IQR)] according to their distribution (tested by Shapiro–Wilk). Categorical variables were expressed as frequencies and percentages. Between-group comparisons were performed using the Student’s t-test or Mann–Whitney U test for continuous variables and X 2 or Fisher’s exact test for categorical variables. Correlations were assessed using Spearman’s rank test. Statistical significance was set at p<0.05.Results Among 39 anti-SSA/SSB–positive SLE patients (mean age 50±12 years; 84.6% female), 16 (41.0%) showed positive SGUS findings ( table 1). SGUS-positive patients were significantly younger than SGUS-negative ones (44±12 vs 54±11 years, p=0.013) and exclusively female (p=0.026). From SGUS-positive patients, 43.8% presented sicca symptoms. Sicca symptoms were present in 35.9% of the whole study population, xerostomia in 28.2% and xerophthalmia in 10.3%, with comparable frequencies between SGUS-positive and SGUS-negative patients (p=0.63 and p=0.70, respectively (table 2).Abstract PO:03:094 Table 1Baseline characteristics of anti-SSA-SSB–positive SLE patients (n=39)Abstract PO:03:094 Table 2Comparison of clinical and serological variables between SGUS– and SGUS+ groupsConclusions SGUS abnormalities were frequent among anti-SSA/SSB–positive SLE patients, even in the absence of subjective dryness, indicating subclinical salivary gland involvement. These findings suggest that SGUS may help identify a subgroup at increased risk of developing associated Sjögren’s Disease. Prospective studies are needed to explore this hypothesis.