1989 Volume 35 Issue 7 Pages 1836-1847
Male cases with Sjögren's syndrome are uncommon, and its detailed clinical condition is unknown.
In this study, we examined clinical history, clinical symptoms, saliva secretion rate, tear fl ow rate, sialography, histological finding of the labial salivary gland and serum auto-antibodies of 12 male cases with Sjögren's syndrome. Moreover, clinical features of male and female patients of Sjögren syndrome were compared.
The diagnosis and clinical classification of Sjögren's syndrome were based on the criteria established by the Ministry of Health and Welfare Sjögren's Syndrome Committee. Sialographic changes were in five stages according to the classification of Rubin & Holt.
Histological changes of labial salivary gland were in five stages according to the classification of Ishikawa & Komori (1979).
The results were as follows:
1) 8 patients had “definite”, and 4 patients had “probable” Sjögren's syndrome. In clinical classification of Sjögren's syndrome, 10 cases belonged to group I, 1 to group II (rheumatoid arthritis), and 1 to group III (chronic active hepatitis). Age distribution was 27-68 years and mean age was 48.7 years.
2) The incidence rate of male cases in Sjögren's syndrome was 9.0%. In male cases, the incidence rate of Sjögren's syndrome was the highest in the group I.
3) In initial symptom on male cases, the incidence rate of eye symptom was the highest, and eye symptom was observed to be more prominent in male than in female cases.
4) The incidence rate of abnormal sialography finding (stage I to IV) was 27.3% in male and 81.1% in female cases. Slighter abnormal changes of sialography were observed in male than in female cases.
5) The incidence rate of periductal focus of lymphoid cells in labial salivary gland was 30.0% in male and 76.5% in female cases. Slighter labial salivary gland changes were observed in male than in female cases.
6) The decrease of saliva was slighter in male than in female cases.
7) Decreased tear flows by Schirmer's test were severer in male than in female cases. The incidence rate of keratoconjunctivitis sicca was higher in male than in female cases.
8) The incidence rate of serum auto-antibodies was lower in male than in female cases, and especially, these auto-antibodies were not found in group I of male cases.
9) From the above, male cases with Sjögren's syndrome may be characterized by prominent eye symptoms and other poor clinical features.
