Neurological diseases and bullous pemphigoid: A case–control study in Iranian patients

Daneshpazhooh, Maryam; Khorassani, Javad; Balighi, Kamran; Ghandi, Narges; Mahmoudi, Hamidreza; Tohidinik, Hamid Reza; Hamzelou, Shahin; Chams‐Davatchi, Cheyda

doi:10.4103/0378-6323.191132

Cited by 16 publications

(13 citation statements)

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“…The frequency of neurological diseases in their case group was 26.3%. They noted that stroke (17.5%) and dementia (5.6%) were significantly associated with BP [37]. …”

Section: Discussionmentioning

confidence: 99%

Frequency of Neurological Disorders in Bullous Pemphigoid Patients: A Cross-Sectional Study

Khosravani

Handjani

Alimohammadi

et al. 2017

International Scholarly Research Notices

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Background Bullous pemphigoid (BP) is an autoimmune subepidermal blistering skin disorder which occurs mostly in the elderly. Several studies have reported an association between BP and neurological disorders (ND). Objective The purpose of this study was to evaluate the association between BP and neurological disorders in Iranian patients. Methods In this cross-sectional study, 87 patients with BP were enrolled. They were compared to 184 controls. Statistical analysis was done by SPSS statistical software version 19. Results Out of 87 patients with BP, 17 (19.5%) had at least one neurological disease. Cerebrovascular accident (CVA) was the most common neurological disease that was seen in 7 patients (8.0%) in the case group and 4 (2.1%) in the control group. The incidence of CVA was significantly different between BP patients and the control group (P = 0.022). Dementia was observed in 6 patients in the case group (16.8%) and 2 (1.0%) in the control group. The incidence of dementia was significantly different between BP patients and the control group (P = 0.008). In this study, the incidences of Parkinson's disease (P = 0.830), epilepsy (P = 0.067), and multiple sclerosis (P = 0.326) were not statistically significant between the two groups. Conclusion The incidence of CVA and dementia in patients with BP compared to the control group was significantly higher.

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“…The frequency of neurological diseases in their case group was 26.3%. They noted that stroke (17.5%) and dementia (5.6%) were significantly associated with BP [37]. …”

Section: Discussionmentioning

confidence: 99%

Frequency of Neurological Disorders in Bullous Pemphigoid Patients: A Cross-Sectional Study

Khosravani

Handjani

Alimohammadi

et al. 2017

International Scholarly Research Notices

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“…Similarly, in a study including a larger sample of BP patients, Khosravani et al reported no difference between BP patients and controls in terms of MS. Nevertheless, MS has been linked to BP in multiple studies 16,18,22,24 . On the other hand, the risk of Parkinson's disease appears to be higher in BP patients, 22 yet we were not able to evaluate its pattern in our study.…”

Section: Discussionmentioning

confidence: 73%

“…Some studies have shown a higher likelihood of both stroke and dementia in BP patients. [15][16][17][18] On the contrary, some researchers have demonstrated similar dementia rates in BP patients and controls. 10,[19][20][21] We did not observe Alzheimer MRI patterns in these patients, nor did we find such pattern in the control group.…”

Section: Discussionmentioning

confidence: 96%

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Brain MRI findings in patients with bullous pemphigoid: A case–control study

Ganji

Mahboubi-Fooladi

Shahidi‐Dadras

et al. 2023

Experimental Dermatology

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Evidence suggests that bullous pemphigoid (BP) is associated with multiple neurological disorders. We aimed to compare brain magnetic resonance (MRI) findings between BP patients and a control group. This case-control study included patients with BP referred to two dermatology clinics during a two-year period. A group of individuals attending the same clinics for cosmetic procedures were selected as controls. First, participants' general information including age, gender, education, weight and underlying disease was recorded. For BP patients, the drugs and the BP Disease Area Index (BPDAI) were recorded as well. Then, all participants underwent brain MRI without contrast. The Fazekas scale, the general cerebral atrophy (GCA) score, and the Medial Temporal lobe Atrophy (MTA) score were used to assess MRI images. Overall, 24 BP patients and 24 controls were evaluated in this study. Both groups were comparable regarding age, gender and education. However, diabetes and hypertension were more frequent in the control group. The mean BPDAI total score was 51.39 ± 68.92 in BP patients and most of them used rituximab (41.7%). None of the participants had MS or Alzheimer MRI patterns. There was no difference between groups in terms of GCA and MTA scores. Furthermore, the frequency of partially empty sella did not differ significantly between BP patients and controls (p = 0.461); nevertheless, grade-3 Fazekas was significantly higher in BP patients compared to controls (25% vs. 0%, p = 0.019). Of note, one BP patient had an epidermoid cyst and another had moderate enlargement of three ventricles. Also, new infarcts were observed in two and old infarcts in four BP patients. Although the majority of abnormal brain MRI findings were more frequent in BP patients compared to controls, only grade-3 Fazekas was significantly higher and acute infarcts were exclusively observed in BP patients.

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“…The range of age between 80 and 89 years showed the highest association with neuropsychiatric diseases. In the literature, several studies have evaluated the association between mean age of patients with BP and neurological pathologies, showing that patients with neurological comorbidities were generally older than those without (34,39,40). This result may be explained by the concept of immuno-senescence that is an age-related immune dysfunction with a consequent process of autoimmunization against antigens common between the CNS and epidermis (39).…”

Section: Discussionmentioning

confidence: 99%

A Monocentric Retrospective Observational Study of Comorbidities in Patients Affected by Autoimmune Bullous Diseases

Ferranti

Gobbo

Cicogna

et al. 2020

In Vivo

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Background/Aim: Autoimmune bullous diseases (AIBDs) of the skin and mucosae include a heterogeneous group of chronic diseases, which could be associated with various comorbidities. The purpose of this study was to evaluate the comorbidity profiles of patients affected by AIBDs, who referred to the Dermatological Clinic of Padua from December 2015 to June 2018. Patients and Methods: A monocentric retrospective observational study was conducted on 157 patients with diagnosis of AIBDs. Patients' comorbidities were investigated during the periodic visits of follow-up and through the analysis of computerized medical records. Results: Among the 157 patients, 40 (25.5%) were diagnosed with PV, 15 (9.6%) with PF, and 102 (64.9%) with BP. Nine different comorbidities were observed, but only two of these were statistically significantly associated with BP: type 2 diabetes (p=0.0142) and neuropsychiatric disorders (p=0.015). Conclusion: BP is statistically significantly associated with type 2 diabetes mellitus and neuropsychiatric diseases. The correlation with neuropsychiatric pathologies is interesting for the possible bidirectional role in their etiology. The association with type 2 diabetes mellitus could suggest more caution in the administration of systemic corticosteroids, especially in elderly patients.

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Neurological diseases and bullous pemphigoid: A case–control study in Iranian patients

Abstract: Neurological diseases in general, and stroke and dementia in particular, were significantly associated with bullous pemphigoid in our study.

Cited by 16 publications

References 0 publications

Frequency of Neurological Disorders in Bullous Pemphigoid Patients: A Cross-Sectional Study

Frequency of Neurological Disorders in Bullous Pemphigoid Patients: A Cross-Sectional Study

Brain MRI findings in patients with bullous pemphigoid: A case–control study

A Monocentric Retrospective Observational Study of Comorbidities in Patients Affected by Autoimmune Bullous Diseases

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