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Long-term follow-up in primary Sjögren's syndrome reveals differences in clinical presentation between female and male patients
Karolinska Univ Hosp, Karolinska Inst, Dept Med, Unit Expt Rheumatol, SE-17176 Stockholm, Sweden..
Karolinska Univ Hosp, Karolinska Inst, Dept Med, Unit Expt Rheumatol, SE-17176 Stockholm, Sweden..
Linkoping Univ, Div Rheumatol, Dept Clin Expt Med, Linkoping, Sweden..
Skane Univ Hosp, Dept Rheumatol, Malmo, Sweden..
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2017 (English)In: Biology of Sex Differences, ISSN 2042-6410, Vol. 8, article id 25Article in journal (Refereed) Published
Abstract [en]

Background: Despite men being less prone to develop autoimmune diseases, male sex has been associated with a more severe disease course in several systemic autoimmune diseases. In the present study, we aimed to investigate differences in the clinical presentation of primary Sjogren's syndrome (pSS) between the sexes and establish whether male sex is associated with a more severe form of long-term pSS. Methods: Our study population included 967 patients with pSS (899 females and 68 males) from Scandinavian clinical centers. The mean follow-up time (years) was 8.8 +/- 7.6 for women and 8.5 +/- 6.2 for men (ns). Clinical data including serological and hematological parameters and glandular and extraglandular manifestations were compared between men and women. Results: Male patient serology was characterized by more frequent positivity for anti-Ro/SSA and anti-La/SSB (p = 0. 02), and ANA (p = 0.02). Further, men with pSS were more frequently diagnosed with interstitial lung disease (p = 0. 008), lymphadenopathy (p = 0.04) and lymphoma (p = 0.007). Conversely, concomitant hypothyroidism was more common among female patients (p = 0.009). Conclusions: We observe enhanced serological responses and higher frequencies of lymphoma-related extraglandular manifestations in men with pSS. Notably, lymphoma itself was also significantly more common in men. These observations may reflect an aggravated immune activation and a more severe pathophysiological state in male patients with pSS and indicate a personalized managing of the disease due to the influence of the sex of patients with pSS.

Place, publisher, year, edition, pages
BioMed Central, 2017. Vol. 8, article id 25
Keyword [en]
Sjogren's syndrome, Autoimmunity, Sex difference, Disease severity, Extraglandular manifestations
National Category
Endocrinology and Diabetes Genetics
Identifiers
URN: urn:nbn:se:uu:diva-334043DOI: 10.1186/s13293-017-0146-6ISI: 000407219000001PubMedID: 28789696OAI: oai:DiVA.org:uu-334043DiVA, id: diva2:1159050
Note

Jennifer Meadows is a member of the DISSECT consortium.

Available from: 2017-11-21 Created: 2017-11-21 Last updated: 2018-02-19Bibliographically approved

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Rönnblom, LarsBaecklund, EvaNordmark, GunnelMeadows, Jennifer
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