A Retrospective Comparative Study On Simple Bullous Pemphigoid And Bullous Pemphigoid With Nervous System Diseases

Objective:To study the clinical features, laboratory examination results, therapy, and prognosis of the patients who were diagnosed bullous pemphigoids (BP) with or without neurological diseases(ND) concomitantly and to search the difference of the pathogenesy, clinical feature, therapy and prognosis between the two identities.Method:To collect the related data of the BP cases that were diagnosed in the First Affiliated Hospital of Dalian Medical University during the 11-yearperiod (1998-2009). A retrospective study was made to those patients who were divided into Groups A and B according to who were without or with neurological disorders respectively.The simple BP is Group A, the BP with ND is Group B.Result:①The disposition of blister is different between A and B. The blisters emerged on the terminal of limbs more easyly in Group B,and it is pantomorphia.②33 patients were with hypoproteinemia, accounting for 44% of all the patients. The patients with hypoproteinemia in Group B were more than in Group A (P<0.05).③38 patients were with infection, accounting for 50.67% of all the patients. The patients with infection in Group B were more than in Group A (P<0.05).④32 patients with eosinophilia, accounting for 42.67% of all the patients. The patients with eosinophilia in Group B were more than in Group A (P>0.05).⑤On average, the patients in Group A were prescribed the glucocorticoid with 0.89 mg/kg/d as initial dose for 9.87 days and the patients in Group B were prescribed the glucocorticoid with 1.28 mg/kg/d as initial dose for 10.51 days. The amount of glucocorticoid was higher in Group B than in Group A (P<0.01).⑥Prognosis of relapse and mortality in two groups had significant differences. The mortality rate was significantly higher in Group B than in Group A (P<0.05).Conclusion:1,There were significantly differences between the two groups on the aspects of complicating with infection, hypoproteinemia, glucocorticoid dosage, and prognosis.The BP with neurological disease is easier to complicating with infection, hypoproteinemia.And it needed higher-dose glucocorticoid, and prognosis is worse.2,The prognosis of the bullous pemphigoids is related to the dose of the glucocorticoid. Higher-dose glucocorticoid (≥1mg/kg/d) treatment was associated with a poor prognosis.