TY - JOUR
T1 - Vitiligo and Crohn′s disease form an autoimmune cluster
T2 - insights from a population-based study
AU - Kridin, Khalaf
AU - Goral, Daniel
AU - Shihade, Wesal
AU - Tzur-Bitan, Dana
AU - Onn, Erez
AU - Zoller, Lilach
AU - Cohen, Arnon D.
N1 - Publisher Copyright:
© 2022 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2023/4
Y1 - 2023/4
N2 - Background: While the coexistence of vitiligo and Crohn′s disease (CD) has been reported in individual patients, the epidemiological association between these autoimmune conditions remains inconclusive. Objective: To assess the bidirectional association between vitiligo and CD. Methods: A population-based study was performed to compare vitiligo patients (n = 20,851) with age-, sex- and ethnicity-matched control subjects (n = 102,475) regarding the incidence of new-onset and the prevalence of preexisting CD. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were calculated by multivariable Cox regression and logistic regression, respectively. Results: The incidence rate of new-onset CD was evaluated at 3.6 (95% CI, 2.7–4.9) cases per 10,000 person-years (PY) in patients with vitiligo and 2.4 (95% CI, 2.0–2.9) cases per 10,000 PY in controls. Patients with vitiligo experienced an elevated risk of CD (fully adjusted HR, 1.60; 95% CI, 1.10–2.34; p = 0.015). Congruently, a history of preexisting CD predicted elevated odds of having subsequent vitiligo (fully adjusted OR, 1.49; 95% CI, 1.15–1.93; p = 0.002). Compared to other patients with vitiligo, those with vitiligo and comorbid CD were older and had a higher prevalence of diabetes mellitus, hyperlipidemia, and hypertension but a comparable all-cause mortality rate. Conclusions: The current study depicts a robust bidirectional association between vitiligo and CD. This knowledge is of clinical implication for physicians managing patients with both conditions. The diagnostic threshold for CD should be lowered in vitiligo patients with compatible symptoms.
AB - Background: While the coexistence of vitiligo and Crohn′s disease (CD) has been reported in individual patients, the epidemiological association between these autoimmune conditions remains inconclusive. Objective: To assess the bidirectional association between vitiligo and CD. Methods: A population-based study was performed to compare vitiligo patients (n = 20,851) with age-, sex- and ethnicity-matched control subjects (n = 102,475) regarding the incidence of new-onset and the prevalence of preexisting CD. Adjusted hazard ratios (HRs) and adjusted odds ratios (ORs) were calculated by multivariable Cox regression and logistic regression, respectively. Results: The incidence rate of new-onset CD was evaluated at 3.6 (95% CI, 2.7–4.9) cases per 10,000 person-years (PY) in patients with vitiligo and 2.4 (95% CI, 2.0–2.9) cases per 10,000 PY in controls. Patients with vitiligo experienced an elevated risk of CD (fully adjusted HR, 1.60; 95% CI, 1.10–2.34; p = 0.015). Congruently, a history of preexisting CD predicted elevated odds of having subsequent vitiligo (fully adjusted OR, 1.49; 95% CI, 1.15–1.93; p = 0.002). Compared to other patients with vitiligo, those with vitiligo and comorbid CD were older and had a higher prevalence of diabetes mellitus, hyperlipidemia, and hypertension but a comparable all-cause mortality rate. Conclusions: The current study depicts a robust bidirectional association between vitiligo and CD. This knowledge is of clinical implication for physicians managing patients with both conditions. The diagnostic threshold for CD should be lowered in vitiligo patients with compatible symptoms.
KW - Crohn′s disease
KW - association
KW - comorbidity
KW - epidemiology
KW - vitiligo
UR - http://www.scopus.com/inward/record.url?scp=85139972180&partnerID=8YFLogxK
U2 - 10.1080/00365521.2022.2131332
DO - 10.1080/00365521.2022.2131332
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C2 - 36222357
AN - SCOPUS:85139972180
SN - 0036-5521
VL - 58
SP - 354
EP - 359
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 4
ER -