Studies show that pSS patients with late disease onset have lower levels of autoantibodies such as RF, ANA, anti-Ro/SSA, or anti-La/SSB antibodies in comparison to younger pSS patients.[8,10,28,32] Our results demonstrated that the level of inflammatory biomarkers (ESR) was higher, and the level of C4 was lower in the EopSS patients. This evidence concerns the gene CALR and peeling skin syndrome.