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Journal of the American Academy of Dermatology
Volume 71, n° 6
pages 1191-1197 (décembre 2014)
Doi : 10.1016/j.jaad.2014.07.052
accepted : 28 July 2014
Original Articles

A population-based study of the association between bullous pemphigoid and neurologic disorders
 

Katherine E. Brick, MD a, Chad H. Weaver, MD a, Rodolfo Savica, MD, MSc f, Christine M. Lohse, MS c, Mark R. Pittelkow, MD e, Bradley F. Boeve, MD d, Lawrence E. Gibson, MD a, b, Michael J. Camilleri, MD a, b, Carilyn N. Wieland, MD a, b,
a Department of Dermatology, Mayo Clinic, Rochester, Minnesota 
b Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota 
c Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota 
d Department of Neurology, Mayo Clinic, Rochester, Minnesota 
e Department of Dermatology, Mayo Clinic, Scottsdale, Arizona 
f Department of Neurology, Division of Sleep and Movement Disorders, University of Utah, Salt Lake City, Utah 

Reprint requests: Carilyn N. Wieland, MD, Department of Dermatology, Mayo Clinic, 200 First St SW, Rochester, MN 55905.
Abstract
Background

Bullous pemphigoid (BP) has been associated with neurologic disorders.

Objective

We sought to analyze the association between BP and neurologic disorders.

Methods

We retrospectively identified residents of Olmsted County, Minnesota, with a first lifetime diagnosis of BP between January 1, 1960, and December 31, 2009. Three age- and sex-matched Olmsted County, Minnesota, residents without BP were selected as control subjects for each patient. We compared history of or development of neurologic disorders (dementia, Alzheimer disease, Parkinson disease, multiple sclerosis, cerebrovascular disease, and seizures) between groups using case-control and cohort designs.

Results

In all, 87 patients with BP were identified and matched to 261 control subjects. The odds of a previous diagnosis of any neurologic disorder or a history of dementia were significantly increased among cases compared with controls (odds ratio 6.85; 95% confidence interval [CI] 3.00-15.64; P < .001; and odds ratio 6.75; 95% CI 2.08-21.92; P  = .002, respectively). Both Parkinson disease (hazard ratio 8.56; 95% CI 1.55-47.25; P  = .01) and any type of neurologic disorder (hazard ratio 2.02; 95% CI 1.17-3.49; P  = .01) were significantly more likely to develop during follow-up in patients with than without BP.

Limitations

Small geographic area and retrospective study design are limitations.

Conclusion

Findings confirmed an association of BP with neurologic disorders, especially dementia and Parkinson disease.

The full text of this article is available in PDF format.

Key words : bullous diseases, bullous pemphigoid, epidemiology, immunobullous, immunodermatology, pemphigoid

Abbreviations used : BP, CI, HR, OR



 The Rochester Epidemiology Project supported this project (R01-AG034676; principal investigators: Walter A. Rocca, MD, MPH, and Barbara P. Yawn, MD, MSc).
 Conflicts of interest: None declared.



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