Table 1.
Association between bullous pemphigoid and neurologic and psychiatric diseases.
| Author | Year | Location | Study design | Reference cohort | N (case/control) |
Neurologic/psychiatric comorbidities in individuals with BP |
OR/HR | 95% CI | p |
|---|---|---|---|---|---|---|---|---|---|
| Chen Y.J., et al. (20) | 2011 | Taiwan | Case-control | Age- and sex-matched controls | 3,485/17,425 |
Dementia
Epilepsy Parkinson’s disease Stroke Schizophrenia |
4.81
3.97 3.49 3.30 2.56 |
4.26–5.42
3.28-4.81 3.05-3.98 3.03-3.60 1.56-4.30 |
< 0,003
< 0,003 < 0,003 < 0,003 < 0,003 |
| Yang Y.W., et al. (23) | 2011 | Taiwan | Cohort-study | Age- and sex-matched controls | 390/1,950 | Stroke | 2.37 | 1.78-3.15 | <0.001 |
| Teixeira V. B., et al. (24) | 2014 | Portugal | Case-control | Age- and sex-matched controls | 77/178 |
Stroke
Dementia |
5.22 4.13 |
1.65-15.51
1.42-14.5 |
<0.001
<0.001 |
| Kwan Z., et al. (25) | 2015 | Malaysia | Case-control | Age-, sex- and ethnicity-matched controls | 43/43 |
Neurological disorder
Dementia Stroke Parkinson’s disease Epilepsy |
3.5
n.a. 2.1 n.a. n.a. |
1.2-10.2
n.a. 0.6-7.2 n.a. n.a. |
0.026
0.002 0.237 1.0 0.494 |
| Försti A.K., et al. (8) | 2016 | Finnland | Cohort study | Age- and sex-matched controls | 4,524/66,138 |
Schizophrenia
Personality disorders |
2.7
2.2 |
2.0-3.5
1.3-3.3 |
<0.05
<0.05 |
| Sim B., et al. (26) | 2017 | Singapore | Case-control | Age- and sex-matched controls | 105/315 |
Parkinson’s disease
Stroke Dementia Epilepsy Depression Schizophrenia |
20.59
6.24 5.89 3.75 3.73 4.37 |
4.69-90.5
3.48-11.2 2.87-12.0 1.01-13.9 1.49-9.37 0.37-51.3 |
<0.001
<0.001 <0.001 0.049 0.005 0.24 |
| Daneshpazhooh M., et al. (9) | 2017 | Iran | Case-control | Age- and sex-matched controls | 160/317 |
Stroke
Any neurological disease Dementia Epilepsy Parkinson’s disease Multiple sclerosis |
4.96
3.53 3.09 4.04 1.14 1.00 |
2.49–9.88
2.1–5.90 1.08–8.84 0.73-22.3 0.33-3.94 0.98-1.01 |
< 0.001
< 0.001 < 0.03 0,08 0,84 0,5 |
| Kibsgaard L., et al. (10) | 2017 | Denmark | Matched Cohort study | n.a. | 3,281/32,213 |
Multiple sclerosis
Parkinson’s disease Stroke Alzheimer’s disease |
9.7
4.2 2.7 2.6 |
6.0 – 15.6
3.1 – 5.8 2.4 – 2.9 1.8 – 3.5 |
<0.05
<0.05 <0.05 <0.05 |
| Ren Z., et al. (27) | 2017 | USA | Register study of hospitalized adult patients in the USA |
n.a. | 2,108 BP primary diagnosis 11,234 BP secondary diagnosis 72,108,077 total hospital discharges |
Multiple sclerosis
Demyelinating disorders Presenile dementia Paralysis Other neurological disorders Parkinson’s disease Other dementias Vascular dementia Senile dementia Epilepsy Psychoses Depression |
4.07
3.57 2.63 2.52 1.98 1.86 1.71 1.67 1.67 1.67 1.25 1.19 |
3.22-5.14
1.48-8.61 1.34-5.18 2.30-2.77 1.65-2.10 1.86-2.11 1.51-1.94 1.40-2.00 1.41-1.98 1.41-1.98 1.12-1.39 1.11-1.28 |
0.0003
0.01 0.01 0.0003 0.0003 0.0003 0.0003 0.0003 0.0003 0.0003 0.0003 0.0003 |
| Kalińska-Bienias A., et al. (28) | 2019 | Poland | Case-control | Age- and sex-matched controls | 218/168 |
Dementia
Neurologic disease |
7.89
3.76 |
2.99-20.85
2.13-6.65 |
<0.001
<0.001 |
| Papakonstantinou E., et al. (29) | 2019 | Germany | Cohort-study | Age- and sex-matched controls | 183/348 |
Neurological disorder
Dementia Stroke Parkinson’s disease Alzheimer’s disease |
10.8
9.9 4.1 2.9 0.3 |
6.9–16.7
5.4-17.8 1.7-9.7 1.0-8.4 0.0-7.9 |
<0.001
<0.001 0.0015 0.0434 0.5303 |
| Rania M, et al. (12) | 2020 | Denmark | Cohort study (national register) | Adjustment for medication | 2,892/6,470,450 | Subsequent BP in - Any psychiatric disorder - Organic disorder - Substance use disorder - Schizophrenia - neurotic disorder - personality disorder - intellectual disorder |
1.4 1.55 1.70 1.57 1.41 1.53 2.96 |
1.25-1.56 1.32-1.81 1.35-2.13 1.21-2.02 1.16-1.71 1.22-1.92 1.58-5.51 |
n.a. n.a. n.a. n.a. n.a. n.a. n.a. |
| Kridin K., et al. (11) | 2021 | Germany | Cross-sectional study | Age- and sex-matched controls | 1,743/10,141 |
Parkinson’s disease
Epilepsy Alzheimer’s disease Stroke |
2.71
2.18 2.11 1.84 |
2.19-3.35
1.72-2.77 1.73-2.57 1.55-2.19 |
<0.001
<0.001 <0.001 <0.001 |
| Kilic Sayar S., et al. (30) | 2021 | Turkey | Case-control | Age- and sex-matched controls | 145/310 |
Stroke
Neurological disorder Parkinson’s disease Alzheimer’s disease Dementia |
2.29
1.94 1.28 1.69 2.20 |
1.15-4.56
1.12-3.35 0.30-5.46 0.61-4.64 0.81-5.99 |
0.017
0.017 0.731 0.304 0.122 |
| Sánchez-García V., et al. (2) | 2022 | Spain | Retrospective observational study | Compared to pemphigus patients | 5,424/1,950 | Higher prevalence in BP compared to pemphigus - Dementia - Parkinson’s disease - Cerebrovascular disease - Depression - Epilepsy - Multiple sclerosis |
n.a. n.a. n.a. n.a. n.a. n.a. |
n.a. n.a. n.a. n.a. n.a. n.a. |
<0.001 0.043 0.057 0.087 0.09 0.074 |
| Martin E., et al. (13) | 2022 | Germany | Case-control | Age- and sex-matched controls | 300/583 |
Multiple sclerosis
Dementia Organic brain syndrome Neurological disease Parkinson’s disease Psychiatric disease Epilepsy Stroke Depression |
10.00
7.47 5.50 3.59 3.03 2.441 2.397 2.355 1.799 |
1.16–85.59
4.45–12.54 1.75–17.27 2.56–5.02 1.51–6.08 1.64-3.61 1.11–5.14 1.60–3.45 1.15–2.80 |
<0.05
<0.0005 <0.05 <0.0005 <0.05 <0.0005 <0.05 <0.0005 <0.05 |
| Titou H., et al. (31) | 2022 | Morocco | Case-control | Age- and sex-matched controls | 81/162 | Significant association of BP with any neurological disease and stroke | n.a. | n.a. | 0.001 |
Data in bold indicate statistically significant results.
BP, bullous pemphigoid; OR, odds ratio; HR, hazard ratio; CI, confidence interval; n.a, not available.