Influence of age on the clinical and biological features of systemic sclerosis

Purpose. - The present study was aimed at assessing the influence of age on clinical and biological features of systemic sclerosis. Methods. - This retrospective study included 151 consecutive patients with systemic sclerosis. The median age at diagnosis was 50.0 years (range: 10-8 4 years). Patients were divided into two groups according to their age (low er than 50.0 years of age: 73 patients, equal to or above 50 years of age: 78 patients). The following features were compared between the two groups: gender, disease duration, extent of skin sclerosis, Crest syndrome, lung fi brosis, secondary Sjogren's syndrome, antinuclear, anticentromere, and anti -Scl70 antibodies. Results. - The disease duration was significantly higher in patients over 5 0 years of age (7,1 +/- 6,8 years vs 5,5 +/- 5,0 years, P < 0,05). Crest sy ndrome, secondary Sjogren's syndrome and anticentromere antibodies were sig nificantly more common in patients over 50 years of age (7,1 +/- 6,8 years vs 5,5 +/- 5,0 years, P < 0,05). Crest syndrome, secondary Sjogren's syndro me and anticentromere antibodies were significantly more common in patients over 50 years of age (17/73 vs 30/78, P < 10(-2); 9/73 vs 20/78, P < 10(-2 ), and 19/73 vs 31/78, P < 0,05; respectively). Anti-Scl70 antibodies were significantly more common in patients under 50 years of age (17/73 vs 10/78 , P < 10(-2)). No significant difference was found in regard to the other f eatures. Conclusion. - The clinical and biological patterns of systemic sclerosis ar e different according to the age at disease onset. Crest syndrome including anticentromere antibodies and Sjogren's syndrome is more common in elderly patients, while anti- Scl-70 antibodies are more common in younger patient s. This suggests the involvement of various mechanisms in the pathogenesis of systemic sclerosis, and that these mechanisms may depend on the age. (C) 1999 Editions scientifiques et medicales Elsevier SAS.