Priya M Mathews1, Sarah Hahn1, Michelle Hessen1, Jean Kim2, Thomas Grader-Beck2, Julius Birnbaum2, Alan N Baer2, Esen K Akpek3. 1. Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland. 2. Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland. 3. Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: esakpek@jhmi.edu.
Abstract
PURPOSE: To report the ocular complications of primary Sjögren syndrome (SS) in men. DESIGN: Retrospective cohort study. METHODS: setting: Tertiary-care SS center. PATIENT POPULATION: Total of 163 consecutive primary Sjögren syndrome patients evaluated between January 2007 and March 2013. MAIN OUTCOME MEASURE: Frequency of extraglandular ocular and systemic manifestations and serologic results in men compared to women. RESULTS: Fourteen of the 163 primary SS patients (9%) were men. On initial presentation, men were a decade older (61 vs 50 years, P < .01) and less likely than women to have a prior diagnosis of SS (43% vs 65%, P = .09). A majority of men reported dry eye on presentation (92%), albeit less chronic compared to women (5.9 vs 10.8 years, P = .07). Men were more likely to present with serious ocular complications than women (43% vs 11%, P = .001). Extraglandular systemic complications of SS (ie, vasculitis, interstitial nephritis) were also more common in men (64% vs 40%, P = .07). Further, men were more likely to be negative for anti-SSA/Ro, anti-SSB/La, and antinuclear antibodies than women (36% men vs 11% women, P = .01). CONCLUSION: Men with primary SS have a higher frequency of serious ocular and systemic manifestations. Although primary Sjögren syndrome is typically considered a disease of middle-aged women, it may be underdiagnosed and consequentially more severe in men. Physicians should have a lower threshold to test for SS in men with dry eye.
PURPOSE: To report the ocular complications of primary Sjögren syndrome (SS) in men. DESIGN: Retrospective cohort study. METHODS: setting: Tertiary-care SS center. PATIENT POPULATION: Total of 163 consecutive primary Sjögren syndrome patients evaluated between January 2007 and March 2013. MAIN OUTCOME MEASURE: Frequency of extraglandular ocular and systemic manifestations and serologic results in men compared to women. RESULTS: Fourteen of the 163 primary SS patients (9%) were men. On initial presentation, men were a decade older (61 vs 50 years, P < .01) and less likely than women to have a prior diagnosis of SS (43% vs 65%, P = .09). A majority of men reported dry eye on presentation (92%), albeit less chronic compared to women (5.9 vs 10.8 years, P = .07). Men were more likely to present with serious ocular complications than women (43% vs 11%, P = .001). Extraglandular systemic complications of SS (ie, vasculitis, interstitial nephritis) were also more common in men (64% vs 40%, P = .07). Further, men were more likely to be negative for anti-SSA/Ro, anti-SSB/La, and antinuclear antibodies than women (36% men vs 11% women, P = .01). CONCLUSION:Men with primary SS have a higher frequency of serious ocular and systemic manifestations. Although primary Sjögren syndrome is typically considered a disease of middle-aged women, it may be underdiagnosed and consequentially more severe in men. Physicians should have a lower threshold to test for SS in men with dry eye.