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[Sjögren's syndrome in the elderly].

Armelle Gentric-Tilly1

  • 1Service de Médecine Interne, CHU La Cavale Blanche, 29285 Brest. armelle.gentric@univ-brest.fr

Annales De Medecine Interne
|December 18, 2002
PubMed
Summary

Diagnosing primary Sjögren's syndrome in older adults is challenging due to overlapping symptoms with aging. Systemic manifestations alongside sicca symptoms are key indicators for this immune exocrinopathy.

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Area of Science:

  • Immunology
  • Rheumatology
  • Geriatrics

Context:

  • Sjögren's syndrome is an immune exocrinopathy primarily affecting salivary and lacrimal glands.
  • Primary Sjögren's syndrome occurs independently of other rheumatologic conditions like polyarthritis or lupus erythematosus.
  • Prevalence of Sjögren's syndrome is suggested to increase with age.

Purpose:

  • To address the diagnostic challenges of primary Sjögren's syndrome in the elderly population.
  • To review diagnostic criteria and testing specificities in older adults.
  • To highlight key indicators for diagnosing Sjögren's syndrome in elderly patients.

Summary:

  • The paper focuses on primary Sjögren's syndrome, an immune exocrinopathy characterized by salivary and ocular dryness.
  • Diagnosis in the elderly is complicated as sicca symptoms are common and often iatrogenic.
  • Current diagnostic criteria, such as the European criteria (1993, revised 1996), have limitations in individuals over 60.
  • Tests like Schirmer's test and non-stimulated salivary flow lack specificity in this age group.
  • The diagnostic value of lip salivary gland biopsy (focus score) is also discussed.
  • The diagnosis should be considered when elderly patients present with sicca symptoms coupled with systemic manifestations.

Impact:

  • Improves understanding of Sjögren's syndrome diagnosis in geriatric populations.
  • Highlights the need for refined diagnostic approaches for immune exocrinopathies in the elderly.
  • Emphasizes the importance of considering systemic involvement in the diagnosis of Sjögren's syndrome in older adults.

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