Sjogren's syndrome in the elderly

Etiology

• often overlaps other connective tissue diseases in elderly
• idiopathic

Epidemiology

• female:male ratio 9:1

Clinical manifestations

• increased sicca symptoms
• symptoms on presentation
  • dry eyes, nose, throat, vagina, ears, skin
  • arthralgias
  • myalgias
  • salivary gland enlargement

Laboratory

• lower prevalence* of anti-SSA/Ro
• lower prevalence* of anti-SSB/La
• lower prevalence* of rheumatoid factor (RF)*
• lower prevalence* of high levels of IgG
• labs do not correlated with disease manifestations
• isosthenuria

Differential diagnosis

• infiltrative diseases
  • amyloid
  • sarcoid
  • lymphoma
  • hemochromatosis
• infection
  • HIV
  • hepatitis B or C
  • tuberculosis
  • trachoma
• neurologic - multiple sclerosis
• vasculitis

* relative to younger patients

More general terms

• rheumatologic disorders in the elderly
• Sjogren's syndrome (autoimmune epitheliitis)

Additional terms

• anti-SSA/Ro
• anti-SSB/La
• isothenuria
• sicca syndrome