Geriatric autoimmune diseases: systemic lupus erythematosus, Sjogren's syndrome, and myositis.
Systemic lupus erythematosus (SLE), Sjogren's syndrome (SS), and dermatomyositis (DM)/polymyositis (PM) may be encountered in geriatric patients due to improved survival rates in patients with younger ages of onset or from elderly-onset (EO) disease. EO disease accounts for up to 20% of patients affected by these disorders, and is typically insidious rather than acute. Whereas SS and DM/PM are considered autoimmune diseases with distinct organ specificity, SLE is a systemic disorder that may affect multiple organ systems. Commonly used clinical and laboratory criteria for defining and diagnosing these diseases were largely developed for patients age <65, and need to be modified in the geriatric patient. Therapeutic strategies include attention to ongoing drug regimens, medical comorbidities, and the roles of fatigue, depression, and arthropathy. Each disease may be responsive to low-dose corticosteroids, with a role for first or second-line immunosuppressives as steroid-sparing agents.
Diep
Jenny T
JT
Mount Sinai Medical Center, New York, NY, USA.
Gorevic
Peter D
PD
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D017668:Age of Onset; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D009220:Myositis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012859:Sjogren's Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D015996:Survival Rate; D014481:United States / Q000453:epidemiology
D000305:Adrenal Cortex Hormones