Milani-Nejad Nima, Zhang Myron, Kaffenberger Jessica
Department of Internal Medicine, Division of Dermatology, The Ohio State University Wexner Medical Center, Gahana, Ohio, USA.
College of Medicine, The Ohio State University Wexner Medical Center, Gahana, Ohio, USA.
Eur J Dermatol. 2017 Oct 1;27(5):472-481. doi: 10.1684/ejd.2017.3066.
Studies suggest an association between neurological disorders and bullous pemphigoid. The goal of this systematic review was to characterize the occurrence of neurological disorders in patients with bullous pemphigoid. We performed a systematic review of the current English literature from 1984 to June 1, 2015 for documented cases of coexistent BP and neurological disorders. The literature search resulted in 53 articles meeting the inclusion criteria. Patients with bullous pemphigoid had an increased risk of stroke (OR: 4.43 [95% CI: 2.69-7.28]; p<0.001), dementia (OR: 5.48 [95% CI: 3.26-9.23]; p<0.001), Parkinson's (OR: 3.06 [95% CI: 1.97-4.77]; p< 0.001), and epilepsy/seizures (OR: 22.88 [95% CI: 2.64-198.21]; p = 0.0045). Neurological disorders preceded bullous pemphigoid in the majority of cases with a mean time interval of 6.7 years. The one-year mortality was increased in bullous pemphigoid patients who had concomitant stroke (OR: 2.87 [95% CI: 1.67-4.96]; p<0.001). Bullous pemphigoid patients have an increased association with neurological disorders which may increase mortality.
研究表明神经疾病与大疱性类天疱疮之间存在关联。本系统评价的目的是描述大疱性类天疱疮患者神经疾病的发生情况。我们对1984年至2015年6月1日的英文文献进行了系统评价,以查找并存大疱性类天疱疮和神经疾病的记录病例。文献检索得到53篇符合纳入标准的文章。大疱性类天疱疮患者发生中风的风险增加(比值比:4.43 [95%置信区间:2.69 - 7.28];p<0.001)、痴呆(比值比:5.48 [95%置信区间:3.26 - 9.23];p<0.001)、帕金森病(比值比:3.06 [95%置信区间:1.97 - 4.77];p<0.001)以及癫痫/发作(比值比:22.88 [95%置信区间:2.64 - 198.21];p = 0.0045)。在大多数病例中,神经疾病先于大疱性类天疱疮出现,平均时间间隔为6.7年。伴有中风的大疱性类天疱疮患者的一年死亡率增加(比值比:2.87 [95%置信区间:1.67 - 4.96];p<0.001)。大疱性类天疱疮患者与神经疾病的关联增加,这可能会增加死亡率。