FRI0372 Comparison of clinical features between young and elderly onset in patients with primary sjogren’s syndrome
Authors: M. Kojima, Y. Kaneko, M. Tsukamoto, T. Takeuchi
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Primary Sjogren's syndrome (pSS) generally develops in middle-aged women. Currently, elderly-onset pSS has been increasing, however, differences in clinical and serological features between young-onset and elderly-onset pSS is unclear. <h3>Objectives</h3> The aim of this study was to compare clinical and serological features between young-onset and elderly-onset patients with pSS. <h3>Methods</h3> All patients with pSS diagnosed with 2016 ACR/EULAR classification criteria in our department from 1995 to 2017 were included. Patients were divided into 2 groups according to the age of diagnosis at 65 years old; young-onset and elderly-onset. The symptoms and laboratory findings were compared. <h3>Results</h3> Six hundred twelve pSS patients were reviewed. Five hundred seventy (93%) were female. Four hundred twenty six (70%) were young-onset and the remaining 186 (30%) were elderly-onset. The mean age at pSS diagnosis was 47.8 and 72.4 years old, the ratio of women:men is around 12:1 and 20:1. The observation period from the diagnosis to the last visit was 3.46 and 5.50 years, respectively. At diagnosis, the positivity of anti-SS-A antibody (86.8 vs 73.7%, p&lt;0.001), anti-SS-B antibody (48.3 vs 30.7%, p&lt;0.001), and rheumatoid factor (49.6 vs 35.2%, p&lt;0.01) were significantly higher in the young-onset patients than the elderly-onset patients. Also, the level of platelet cell count (23.0 vs 20.8*10<sup> 4</sup>/μl, p&lt;0.001), IgG (1996 vs 1745 mg/dl, p&lt;0.001) and IgM (154 vs 131 mg/dl, p&lt;0.001) were significantly higher in the young-onset patients. On the other hand, that of white blood cell count (4814 vs 5301/μl, p&lt;0.001), neutrophil count (2822 vs 3201/μl, p&lt;0.001), lymphocyte count (1512 vs 1632/μl, p&lt;0.01), C3 (87.2 vs 93.2 mg/dl, p&lt;0.001), C4 (22.1 vs 24.7 mg/dl, p&lt;0.001), and CH50 (48.2 vs 51.1/ml, p&lt;0.001) were significantly lower in the young-onset patients. While the young-onset patients had higher rate of liver dysfunction (3.99 vs 0.54%, p&lt;0.05), and arthritis (6.81 vs 2.69%, p&lt;0.05), the elderly-onset patients were more frequently complicated with pulmonary disease (4.2 vs 11.8%, p&lt;0.001). The C3 levels in the elderly-onset patients with pulmonary disease were conversely lower than the young-onset patients with pulmonary disease. The incidence of lymphoma was not different between two groups. <h3>Conclusions</h3> Although elderly onset pSS patients have milder symptoms and immune-disturbances than young-onset ones, pulmonary disease was more frequently affected in the elderly-onset patients with a decrease in complement levels, suggesting there may be difference in the pathogensis in pSS according to onset ages and organ involvement. <h3>References</h3> [1] Sjögren syndrome. CMAJ2014;186(15):E579–586. [2] Clinical and immunological characteristics of elderly onset Sjögren's syndrome: a comparison with younger onset disease. J Rheumatol2001;28(4):795–7. <h3>Disclosure of Interest</h3> None declared