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Sjogren's syndrome in the elderly
Etiology:
1) often overlaps other connective tissue diseases in elderly
2) idiopathic
Epidemiology:
- female:male ratio 9:1
Clinical manifestations:
1) increased sicca symptoms
2) symptoms on presentation
a) dry eyes, nose, throat, vagina, ears, skin
b) arthralgias
c) myalgias
d) salivary gland enlargement
Laboratory:
1) lower prevalence* of anti-SSA/Ro
2) lower prevalence* of anti-SSB/La
3) lower prevalence* of rheumatoid factor (RF)*
4) lower prevalence* of high levels of IgG
5) labs do not correlated with disease manifestations
6) isosthenuria
Differential diagnosis:
1) infiltrative diseases
a) amyloid
b) sarcoid
c) lymphoma
d) hemochromatosis
2) infection
a) HIV
b) hepatitis B or C
c) tuberculosis
d) trachoma
4) neurologic - multiple sclerosis
5) vasculitis
* relative to younger patients
Related
anti-SSA/Ro
anti-SSB/La
isothenuria
sicca syndrome
General
rheumatologic disorders in the elderly
Sjogren's syndrome (autoimmune epitheliitis)
References
Weiner S, In: UCLA Intensive Course in Geriatric Medicine
& Board Review, Marina Del Ray, CA, Sept 12-15, 2001