title: Ocular complications of primary Sjögren syndrome in men.
abstract: OBJECTIVE
  To report the ocular complications of primary Sjögren syndrome (SS) in men.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  setting: Tertiary-care SS center.
  
  
  METHODS
  Total of 163 consecutive primary Sjögren syndrome patients evaluated between January 2007 and March 2013.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Priya M
authors.initials: PM
authors.lastname: Mathews
authors.affiliation: Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Hahn
authors.affiliation: Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hessen
authors.affiliation: Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Jean
authors.initials: J
authors.lastname: Kim
authors.affiliation: Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Grader-Beck
authors.affiliation: Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Julius
authors.initials: J
authors.lastname: Birnbaum
authors.affiliation: Jerome L. Greene Sjögren's Syndrome Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Alan N
authors.initials: AN
authors.lastname: Baer
authors.affiliation: 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.
authors.forename: Esen K
authors.initials: EK
authors.lastname: Akpek
mesh_terms: D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D003229:Conjunctival Diseases / Q000209:etiology; D003316:Corneal Diseases / Q000209:etiology; D015352:Dry Eye Syndromes / Q000209:etiology; D005128:Eye Diseases / Q000097:blood / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000209:etiology; D009916:Orbital Diseases / Q000209:etiology; D012189:Retrospective Studies; D015422:Scleral Diseases / Q000209:etiology; D012859:Sjogren's Syndrome / Q000097:blood / Q000150:complications*; D014603:Uveal Diseases / Q000209:etiology; D014657:Vasculitis / Q000209:etiology
chemical_list: D000974:Antibodies, Antinuclear; C035356:SS-A antibodies; C035357:SS-B antibodies