The Association Between Bullous Pemphigoid and Neurological Disorders in A Selected Malaysian Population
- Author:
Zhenli Kwan
;
Yit Nian Lai
;
Chin Chwen Ch’ng
;
Ai Huey Tan
;
Leng Leng
- Publication Type:Journal Article
- Keywords:
Immunobullous disease;
internal disease associated with dermatology;
epidemiology
- MeSH:
Pemphigoid, Bullous
- From:
The Medical Journal of Malaysia
2015;70(2):81-85
- CountryMalaysia
- Language:English
-
Abstract:
Background: An association of bullous pemphigoid with
neurological disorders has been reported. The objectives of
this study were to review the clinical characteristics of
patients with bullous pemphigoid and compare the
association between bullous pemphigoid and various
neurological disorders and comorbidities.
Methods: This was a retrospective case-control study
involving 43 patients with bullous pemphigoid and 43 age-,
sex- and ethnicity-matched controls.
Results: There was a statistically significant association
between bullous pemphigoid and neurological disorders
[Odds Ratio (OR) = 3.5, 95% Confidence Interval (CI) 1.3 to
9.2, p=0.011 and adjusted OR=3.5, 95% CI 1.2-10.3, p=0.026],
in particular for dementia (p=0.002). Although stroke was
more common among patients with bullous pemphigoid,
this association was not statistically significant with OR of
1.9 (95% CI 0.7 to 5.2) and adjusted OR of 2.1 (95% CI 0.6 to
7.2). Similarly both ischaemic stroke (OR 1.5, 95% CI 0.5 to
4.2) and haemorrhagic stroke (OR 1.5, 95% CI 0.2 to 9.7) were
more common. Other neurological disorders more common
among patients with bullous pemphigoid were Parkinson’s
disease and epilepsy. Dyslipidaemia was significantly less
common among patients with bullous pemphigoid (OR 0.4,
95% CI 0.1 to 0.9, p=0.033).
Conclusion: A combination of an inflammatory process,
prothrombotic state and endothelial activation leads to an
increased frequency of neurological disorders among
patients with bullous pemphigoid. Thus, a holistic approach
to patient care, including screening for dementia and control
of comorbidities, should be practised as bullous
pemphigoid affects more than just the skin.
- Full text:P020150724525397404549.pdf
