Elderly onset of primary Sjögren's syndrome: Clinical manifestations, serological features and oral/ocular diagnostic tests. Comparison with adult and young onset of the disease in a cohort of 336 Italian patients

Botsios, Costantino; Furlan, Antonio; Ostuni, Pierantonio; Sfriso, Paolo; Andretta, Marilisa; Ometto, Francesca; Raffeiner, Bernd; Todesco, S; Punzi, Leonardo

doi:10.1016/j.jbspin.2010.05.008

Cited by 60 publications

(66 citation statements)

References 15 publications

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“…SS disease onset is uncommon after the age of 65 or 70 [40, 41]. Older patients with SS, when compared to younger ones, have a lower frequency of serologic abnormalities, such as anti-SSA, anti-SSB, rheumatoid factor and hyperglobulinemia [42].…”

Section: Sjögren Syndromementioning

confidence: 99%

Sjögren Syndrome and Other Causes of Sicca in Older Adults

Baer

2017

Clinics in Geriatric Medicine

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Synopsis Dry eye and dry mouth symptoms are each reported by up to 30% of persons over the age of 65 years, particularly in women. Multiple factors contribute to these symptoms, but medication side effects are the most common. The evaluation of these symptoms requires measures of ocular and oral dryness, some of which can be done by the geriatrician in a clinic setting. Sjögren syndrome is the prototypic disease associated with dryness of the eyes and mouth and predominantly affects women in their peri- and postmenopausal years of life. The diagnosis requires substantive evidence of autoimmune-induced inflammation targeting the salivary or lacrimal glands. With current classification criteria, the diagnosis can only be established if the patient has antibodies to the SSA (Ro) and/or SSB (La) antigens or a labial gland biopsy showing a characteristic pattern and severity of inflammation, in concert with at least one measure of ocular or oral dryness. A diagnosis is important, since this disease is associated with a substantial increased risk of lymphoma and other forms of morbidity. In addition to topical treatment of the mucosal dryness, patients with Sjögren's syndrome may require treatment with systemic immunomodulatory and immunosuppressive agents to manage a variety of “extraglandular” manifestations.

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Section: Sjögren Syndromementioning

confidence: 99%

Sjögren Syndrome and Other Causes of Sicca in Older Adults

Baer

2017

Clinics in Geriatric Medicine

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“…An Italian cohort of 322 consecutive patients with pSS between 1990 and 2007 was studied retrospectively, where pSS was noted in 6% of adults over 65 years of age 22. A Spanish cohort of 223 consecutive pSS patients noted the disease in 14% of adults aged 70–87 years 23…”

Section: Classification Criteriamentioning

confidence: 99%

The epidemiology of Sjögren’s syndrome

Patel¹,

Shahane²

2014

CLEP

226

142

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Sjögren’s syndrome is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of exocrine glands. It can present as an entity by itself, primary Sjögren’s syndrome (pSS), or in addition to another autoimmune disease, secondary Sjögren’s syndrome (sSS). pSS has a strong female propensity and is more prevalent in Caucasian women, with the mean age of onset usually in the 4th to 5th decade. Clinical presentation varies from mild symptoms, such as classic sicca symptoms of dry eyes and dry mouth, keratoconjunctivitis sicca, and xerostomia, to severe systemic symptoms, involving multiple organ systems. Furthermore, a range of autoantibodies can be present in Sjögren’s syndrome (anti-SSA/Ro and anti-SSB/La antibodies, rheumatoid factor, cryoglobulins, antinuclear antibodies), complicating the presentation. The heterogeneity of signs and symptoms has led to the development of multiple classification criteria. However, there is no accepted universal classification criterion for the diagnosis of Sjögren’s syndrome. There are a limited number of studies that have been published on the epidemiology of Sjögren’s syndrome, and the incidence and prevalence of the disease varies according to the classification criteria used. The data is further confounded by selection bias and misclassification bias, making it difficult for interpretation. The aim of this review is to understand the reported incidence and prevalence on pSS and sSS, the frequency of autoantibodies, and the risk of malignancy, which has been associated with pSS, taking into account the different classification criteria used.

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“…Anaya et al implied that the clinical symptoms in children do not fulfill the classical diagnostic criteria which are successfully applied to adults [33]. Botsios et al found that young, adult and elderly patients had similar sensitivity of diagnostic test positivity [34]. In contrast, Nakamura et al showed the prevalence of anti-muscarinic 3 receptor (anti-M3R) antibodies is higher in early-onset SS than in late-onset SS patients [35].…”

Section: Sjögren's Syndromementioning

confidence: 99%

How Does Age at Onset Influence the Outcome of Autoimmune Diseases?

Amador-Patarroyo

Rodríguez

Montoya-Ortiz

2012

Autoimmune Diseases

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The age at onset refers to the time period at which an individual experiences the first symptoms of a disease. In autoimmune diseases (ADs), these symptoms can be subtle but are very relevant for diagnosis. They can appear during childhood, adulthood or late in life and may vary depending on the age at onset. Variables like mortality and morbidity and the role of genes will be reviewed with a focus on the major autoimmune disorders, namely, systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), multiple sclerosis (MS), type 1 diabetes mellitus (T1D), Sjögren's syndrome, and autoimmune thyroiditis (AITD). Early age at onset is a worst prognostic factor for some ADs (i.e., SLE and T1D), while for others it does not have a significant influence on the course of disease (i.e., SS) or no unanimous consensus exists (i.e., RA and MS).

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Elderly onset of primary Sjögren's syndrome: Clinical manifestations, serological features and oral/ocular diagnostic tests. Comparison with adult and young onset of the disease in a cohort of 336 Italian patients

Cited by 60 publications

References 15 publications

Sjögren Syndrome and Other Causes of Sicca in Older Adults

Sjögren Syndrome and Other Causes of Sicca in Older Adults

The epidemiology of Sjögren’s syndrome

How Does Age at Onset Influence the Outcome of Autoimmune Diseases?

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Elderly onset of primary Sjögren's syndrome: Clinical manifestations, serological features and oral/ocular diagnostic tests. Comparison with adult and young onset of the disease in a cohort of 336 Italian patients

Cited by 60 publications

References 15 publications

Sjögren Syndrome and Other Causes of Sicca in Older Adults

Sjögren Syndrome and Other Causes of Sicca in Older Adults

The epidemiology of Sj&ouml;gren&rsquo;s syndrome

How Does Age at Onset Influence the Outcome of Autoimmune Diseases?

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Product

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The epidemiology of Sjögren’s syndrome