Liu Jui-Ming, Hsu Ren-Jun, Chang Fung-Wei, Chiu Feng-Hsiang, Yeh Chia-Lun, Huang Chun-Fa, Chang Shu-Ting, Lee Hung-Chang, Chi Hsin, Lin Chien-Yu
Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan.
Department of Medicine, National Yang-Ming University.
Ther Clin Risk Manag. 2017 Sep 13;13:1205-1211. doi: 10.2147/TCRM.S137662. eCollection 2017.
Scabies is a common and annoying disorder. Pernicious anemia (PA) is a serious disease which, when untreated, leads to death. Mounting evidence suggests that immune-mediated inflammatory processes play a role in the pathophysiology of both diseases. The relationship between these two diseases has not been investigated. We conducted this study to explore the potential relationship between scabies and PA.
This nationwide, population-based study was conducted using the National Health Insurance Research Database of Taiwan. In total, 5,407 patients with scabies were identified as a study group and 20,089 matched patients were randomly selected as a control group. We tracked patients in both groups for a 7-year period to identify the incidence of PA. The demographic characteristics and comorbidities of the patients were analyzed, and Cox proportional hazards regression was used to calculate the hazard ratios for PA.
Of the 25,496 patients in this study, 183 (0.7%) patients with newly diagnosed PA were identified during the 7-year follow-up period; 71 of 5,407 (1.3%) from the scabies group and 112 of 20,089 (0.6%) from the control group. Patients with scabies had a higher risk of subsequent PA, with a crude hazard ratio of 2.368. After adjusting for covariates, the adjusted hazard ratio was 1.51 (95% confidence interval: 1.09-2.08).
This study demonstrated an increased risk of PA (adjusted hazard ratio 1.51) among patients with scabies. Immune-mediated inflammatory processes may contribute to this association. Further studies are warranted to investigate the entire pathological mechanisms between these two diseases. Physicians should pay attention to patients with history of scabies presented with anemia. Further confirmative tests of PA may contribute to correct diagnosis and initiation of vitamin B12 supplement.
疥疮是一种常见且令人烦恼的疾病。恶性贫血（PA）是一种严重疾病，若不治疗会导致死亡。越来越多的证据表明，免疫介导的炎症过程在这两种疾病的病理生理学中均起作用。这两种疾病之间的关系尚未得到研究。我们开展这项研究以探索疥疮与PA之间的潜在关系。
这项基于全国人群的研究使用了台湾地区的国民健康保险研究数据库。总共，5407例疥疮患者被确定为研究组，随机选取20089例匹配患者作为对照组。我们对两组患者进行了7年的随访，以确定PA的发病率。分析了患者的人口统计学特征和合并症，并使用Cox比例风险回归计算PA的风险比。
在本研究的25496例患者中，在7年随访期间确定了183例（0.7%）新诊断为PA的患者；疥疮组5407例中有71例（1.3%），对照组20089例中有112例（0.6%）。疥疮患者随后发生PA的风险更高，粗风险比为2.368。在对协变量进行调整后，调整后的风险比为1.51（95%置信区间：1.09 - 2.08）。
本研究表明疥疮患者发生PA的风险增加（调整后的风险比为1.51）。免疫介导的炎症过程可能促成了这种关联。有必要进行进一步研究以探究这两种疾病之间的整个病理机制。医生应关注有疥疮病史且出现贫血的患者。PA的进一步确诊检查可能有助于正确诊断并开始补充维生素B12。
