title: A population-based study of the association between bullous pemphigoid and neurologic disorders.
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.
  
  
  CONCLUSIONS
  Small geographic area and retrospective study design are limitations.
  
  
  CONCLUSIONS
  Findings confirmed an association of BP with neurologic disorders, especially dementia and Parkinson disease.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Brick
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Chad H
authors.initials: CH
authors.lastname: Weaver
authors.affiliation: Department of Neurology, Division of Sleep and Movement Disorders, University of Utah, Salt Lake City, Utah.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Savica
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Lohse
authors.affiliation: Department of Dermatology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Bradley F
authors.initials: BF
authors.lastname: Boeve
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Gibson
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Camilleri
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota. Electronic address: wieland.carilyn@mayo.edu.
authors.forename: Carilyn N
authors.initials: CN
authors.lastname: Wieland
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000453:epidemiology*; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D003704:Dementia / Q000453:epidemiology; D004827:Epilepsy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009103:Multiple Sclerosis / Q000453:epidemiology; D016017:Odds Ratio; D010300:Parkinson Disease / Q000453:epidemiology*; D010391:Pemphigoid, Bullous / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies
keywords: bullous diseases; bullous pemphigoid; epidemiology; immunobullous; immunodermatology; pemphigoid