Heelan K, Mahar A L, Walsh S, Shear N H
Division of Dermatology, ON, Canada.
Department of Public Health Sciences, Queen's University , Kingston, ON, Canada.
Clin Exp Dermatol. 2015 Aug;40(6):593-9. doi: 10.1111/ced.12634. Epub 2015 Mar 18.
Pemphigus is a rare autoimmune blistering disease, reported to be associated with other coexisting and autoimmune diseases, including thyroid diseases, rheumatoid arthritis, alopecia areata, vitiligo, systemic lupus erythematosus, scleroderma and rare entities such as myasthenia gravis.
To identify and describe patients with pemphigus with a diagnosed comorbidity, and to quantify the risk of additional comorbidities.
This was a cross-sectional study of patients with pemphigus treated at a tertiary referral centre. Prevalence rates of 15 comorbid diseases were calculated. Age-standardized prevalence ratio (SPR) and 95% CI were calculated in comparison with prevalence rates in the general Canadian population using data from the Canadian Community Health Survey. Data were analysed using SAS software.
In total, 295 patients were identified. An increased risk of hypothyroidism (n = 38, SPR = 1.53, 95% CI 1.08-2.10) and inflammatory bowel disease (IBD) (SPR = 1.48, 95% CI 0.40-3.80), and a two-fold increased risk of diabetes (SPR = 2.20, 95% CI 1.64-2.87) were observed.
Patients with pemphigus have a higher incidence of hypothyroidism, IBD and diabetes compared with the general population. As part of pemphigus investigations and surveillance, investigating for these conditions may be considered.
天疱疮是一种罕见的自身免疫性水疱病，据报道与其他并存的自身免疫性疾病有关，包括甲状腺疾病、类风湿关节炎、斑秃、白癜风、系统性红斑狼疮、硬皮病以及重症肌无力等罕见病症。
识别并描述患有已确诊合并症的天疱疮患者，并量化其他合并症的风险。
这是一项对在三级转诊中心接受治疗的天疱疮患者进行的横断面研究。计算了15种合并疾病的患病率。使用加拿大社区健康调查的数据，与加拿大普通人群的患病率相比，计算年龄标准化患病率比（SPR）和95%置信区间（CI）。数据使用SAS软件进行分析。
总共识别出295名患者。观察到甲状腺功能减退症（n = 38，SPR = 1.53，95% CI 1.08 - 2.10）和炎症性肠病（IBD）（SPR = 1.48，95% CI 0.40 - 3.80）的风险增加，以及糖尿病风险增加两倍（SPR = 2.20，95% CI 1.64 - 2.87）。
与普通人群相比，天疱疮患者甲状腺功能减退症、IBD和糖尿病的发病率更高。作为天疱疮调查和监测的一部分，可以考虑对这些病症进行调查。
