title: 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.
abstract: OBJECTIVE
  To study and compare the clinical and serological features of patients with elderly versus adult and younger onset of primary Sjögren's syndrome (pSS).
  
  
  METHODS
  We analyzed retrospectively 336 consecutive pSS patients followed at our unit. They were subdivided into three groups according to the age at disease onset: elderly (>65 years), adult (>40 and ≤65 years), and young (≤40 years). Clinical and immunological features of the disease, labial salivary glands biopsy, ocular and oral tests were collected at time of diagnosis and then compared among the three groups.
  
  
  RESULTS
  In 21 (6%) patients, disease onset occurred after the age of 65 years. At the time of diagnosis, 15 (71.4%) of these patients reported symptoms of dry mouth and 16 (76.1%) of dry eye. The most common extraglandular manifestation were arthralgias in 14 (66.7%), Raynaud's phenomenon in five (23.8%) and purpura in three (14.2%) cases. Ocular diagnostic tests (Schirmer's I and Rose-Bengal staining) were positive respectively in 17 (80%) and nine (44.4%) patients. In eight (38%) cases, unstimulated whole salivary flow showed normal values, while 12 patients (57.1%) showed positivity for salivary sialography. A focus score greater or equal to 1 per 4mm(2) was demonstrated in 11 (53.3%) of the 21 cases.
  
  
  CONCLUSIONS
  Elderly onset of pSS was associated with similar incidence of the diagnostic tests positivity (parotid sialography, ocular tests, minor salivary gland biopsy) in comparison with adult and younger onset. Moreover, no statistical differences were found among the three groups concerning sex, disease duration, as well as ocular and oral symptoms.
authors.affiliation: Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Padova, via Giustiniani 2, 35128 Padova, Italy. constantin.botsios@unipd.it
authors.forename: Costantino
authors.initials: C
authors.lastname: Botsios
authors.forename: Antonio
authors.initials: A
authors.lastname: Furlan
authors.forename: Pierantonio
authors.initials: P
authors.lastname: Ostuni
authors.forename: Paolo
authors.initials: P
authors.lastname: Sfriso
authors.forename: Marilisa
authors.initials: M
authors.lastname: Andretta
authors.forename: Francesca
authors.initials: F
authors.lastname: Ometto
authors.forename: Bernd
authors.initials: B
authors.lastname: Raffeiner
authors.forename: Silvano
authors.initials: S
authors.lastname: Todesco
authors.forename: Leonardo
authors.initials: L
authors.lastname: Punzi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001706:Biopsy; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine; D005123:Eye / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology; D012189:Retrospective Studies; D012469:Salivary Glands / Q000473:pathology; D012859:Sjogren's Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D001323:Autoantibodies