Neurological diseases and bullous pemphigoid: A case-control study in Iranian patients.
BACKGROUND
Neurological diseases are important co-morbidities found in association with bullous pemphigoid. Various neurological conditions (stroke, Parkinson's disease, dementia, epilepsy and multiple sclerosis) have been reported as associations of this bullous disease; whether these are significant has not been definitely proved. However, the presence of neurological conditions is a predictor of poorer prognosis.


OBJECTIVE
Our aim was to examine the association of bullous pemphigoid and neurological diseases in Iranian bullous pemphigoid patients.


METHODS
The medical records of one hundred and sixty consecutive bullous pemphigoid patients who presented to the Autoimmune Bullous Diseases Research Center, Tehran, Iran, from 2006 to 2011 were examined for evidence of any neurological disease. The control group comprised of 317 age- and sex-matched subjects.


RESULTS
Neurological diseases were seen in 42 (26.4%) patients with bullous pemphigoid and in 29 (9.1%) controls (odds ratio: 3.53 (2.1-5.9), P< 0.001). Comparing cases to controls, stroke was seen in 17.5% versus 4.1%, odds ratio 4.96 (2.49-9.88); dementia in 5.6% versus 1.9%, odds ratio 3.09 (1.08-8.84); Parkinson's disease in 2.5% versus 2.2%, odds ratio 1.14 (0.33-3.94); epilepsy in 2.5% versus 0.6%, odds ratio 4.04 (0.73-22.3); and multiple sclerosis in 0 versus 0.3% odds ratio 1.00 (0.98-1.01).


CONCLUSIONS
The main limitations of our study were referral bias, retrospective design and a rather low sample size.


CONCLUSIONS
Neurological diseases in general, and stroke and dementia in particular, were significantly associated with bullous pemphigoid in our study.
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Maryam
M
Daneshpazhooh
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Javad
J
Khorassani
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Kamran
K
Balighi
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Narges
N
Ghandi
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Hamidreza
H
Mahmoudi
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran; School of Public Health, Gonabad University of Medical Sciences, Gonabad, Iran.
Hamidreza
H
Tohidinik
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Shahin
S
Hamzelou
Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Cheyda
C
Chams-Davatchi
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D010391:Pemphigoid, Bullous / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D055815:Young Adult