Clinical and immunological characteristics of elderly onset Sjogren's syndrome: A comparison with younger onset disease

Objective. To compare the clinical and laboratory characteristics of patien ts with primary Sjogren's syndrome (SS) with an elderly onset to those with a younger onset. Methods. The study group comprised 85 consecutive patients (79 women and 6 men) attending the Sjogren's clinic. Primary SS was diagnosed according to the San Diego criteria. Elderly onset disease (EOD) was determined as the a ppearance of symptoms suggestive of SS after age 65. Clinical and laborator y variables for EOD were compared to those of a younger onset disease (YOD) . Salivary and serum samples of all patients were examined for concentratio ns of interleukin 6 (IL-6) and hyaluronic acid (HA). Results. Seventeen patients with SS (20%) matched the definition of EOD and their median disease onset was 71 years(range 65-80). No significant diffe rences were noted in the clinical disease manifestations between the 2 grou ps of patients. Rheumatoid factor and anti-Ro(SSA) antibodies were more com mon in the YOD group (p = 0.012 and p = 0.023. respectively). Significant e levations of salivary IL-6 and HA levels were detected in the YOD group com pared to the EOD group with SS (17.3 +/- 3.6 vs 8.8 +/- 2.1 pg/ml and 230.2 +/- 41.1 vs 128.8 +/- 33.3 ng/ml. respectively) (p < 0.0001). Conclusion. EOD SS has somewhat milder clinical symptoms with fewer immunol ogical manifestations than YOD. The elevations of salivary IL-6 and HA in t he younger group of SS patients support in part the differences in the infl ammatory process between the 2 groups.