Difference in clinical presentation between women and men in incident primary Sjögren’s syndromeReport as inadecuate




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Biology of Sex Differences

, 8:16

First Online: 12 May 2017Received: 24 January 2017Accepted: 25 April 2017DOI: 10.1186-s13293-017-0137-7

Cite this article as: Ramírez Sepúlveda, J.I., Kvarnström, M., Brauner, S. et al. Biol Sex Differ 2017 8: 16. doi:10.1186-s13293-017-0137-7

Abstract

BackgroundA more severe disease phenotype has been reported in men compared to women in several rheumatic diseases. However, studies have not conclusively established sex-related clinical features in primary Sjögren’s syndrome pSS. In this study, we therefore investigated the clinical presentation of pSS in women and men at diagnosis.

MethodsIncident, treatment naïve patients n = 199 during a 5-year period in a specified area were prospectively included and examined for items of classification criteria for pSS as well as extraglandular manifestations EGM. Serum was sampled at the time of diagnosis and anti-Ro52-SSA levels were measured by ELISA. Replication of significant findings was confirmed in an independent cohort of pSS patients n = 377, and meta-analysis was performed.

ResultsAn increased frequency of extraglandular manifestations in men was observed and replicated p = 0.05, p = 0.0003, and pmeta = 0.002. This related to pulmonary involvement, vasculitis, and lymphadenopathy being more common in men, for whom a lower age at diagnosis was observed in the exploratory cohort. Additionally, SSA-positive male patients had significantly higher levels of anti-Ro52 levels than their female counterparts in sera available for analysis p = 0.02.

ConclusionsOur analysis of two independent cohorts of incident pSS demonstrates that the presence and number of EGM are significantly more frequent among men with pSS than women at diagnosis. Importantly, around half of the male patients presented with more than one EGM at diagnosis, supporting the conclusion that pSS in men represents a more severe form of disease, regardless of the lower risk for men to develop pSS.

KeywordsSjögren’s syndrome Autoimmunity Extraglandular manifestations Sex differences Disease severity 



Author: Jorge I. Ramírez Sepúlveda - Marika Kvarnström - Susanna Brauner - Chiara Baldini - Marie Wahren-Herlenius

Source: https://link.springer.com/







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