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

Katherine E. Brick, Chad H. Weaver, Rodolfo Savica, Christine M. Lohse, Mark R. Pittelkow, Bradley F Boeve, Lawrence E. Gibson, Michael J. Camilleri, Carilyn N. Wieland

Research output: Contribution to journalArticle

50 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1191-1197
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume71
Issue number6
DOIs
StatePublished - Dec 1 2014

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Bullous Pemphigoid
Nervous System Diseases
Population
Confidence Intervals
Parkinson Disease
Dementia
Small-Area Analysis
Odds Ratio
Cerebrovascular Disorders
Multiple Sclerosis
Alzheimer Disease
Seizures
Retrospective Studies

Keywords

  • bullous diseases
  • bullous pemphigoid
  • epidemiology
  • immunobullous
  • immunodermatology
  • pemphigoid

ASJC Scopus subject areas

  • Dermatology

Cite this

A population-based study of the association between bullous pemphigoid and neurologic disorders. / Brick, Katherine E.; Weaver, Chad H.; Savica, Rodolfo; Lohse, Christine M.; Pittelkow, Mark R.; Boeve, Bradley F; Gibson, Lawrence E.; Camilleri, Michael J.; Wieland, Carilyn N.

In: Journal of the American Academy of Dermatology, Vol. 71, No. 6, 01.12.2014, p. 1191-1197.

Research output: Contribution to journalArticle

Brick, Katherine E. ; Weaver, Chad H. ; Savica, Rodolfo ; Lohse, Christine M. ; Pittelkow, Mark R. ; Boeve, Bradley F ; Gibson, Lawrence E. ; Camilleri, Michael J. ; Wieland, Carilyn N. / A population-based study of the association between bullous pemphigoid and neurologic disorders. In: Journal of the American Academy of Dermatology. 2014 ; Vol. 71, No. 6. pp. 1191-1197.
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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.",
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AU - Brick, Katherine E.

AU - Weaver, Chad H.

AU - Savica, Rodolfo

AU - Lohse, Christine M.

AU - Pittelkow, Mark R.

AU - Boeve, Bradley F

AU - Gibson, Lawrence E.

AU - Camilleri, Michael J.

AU - Wieland, Carilyn N.

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N2 - 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.

AB - 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.

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