Association between atopic dermatitis and autoimmune disorders in US adults and children: A cross-sectional study

Publication date: Available online 1 October 2018

Source: Journal of the American Academy of Dermatology

Author(s): Shanthi Narla, Jonathan I. Silverberg

Abstract

Background

Little is known about the risk and predictors of autoimmune diseases in children and adults.

Objective

To determine the prevalence, predictors and excess costs of autoimmune disease in AD patients.

Methods

Cross-sectional study of the 2002–2012 National Inpatient Sample, including a ∼20% sample of all US hospitalizations (n=87,053,155 adults and children).

Results

The prevalence [95% confidence interval {CI95}] of autoimmune disease was higher in adults (7.9% [7.3-8.5%] vs. 5.7 [5.7-5.8%]) and children (2.0% [1.7-2.3%] vs. 1.0% [0.9-1.1%]) with vs. without AD. In multivariable logistic regression models controlling for socio-demographics, adult (adjusted odds ratio [CI95]: 1.45 [1.32-1.8]) and pediatric (2.08 [1.73-2.50]) AD were associated with any autoimmune disorder. In particular, AD was associated with 18 of 32 autoimmune disorders examined in adults and 12 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had higher cost of inpatient care with $2.5-$50 million excess annual costs.

Conclusions

Adults and children with AD had increased cutaneous and extra-cutaneous autoimmune disorders, which were associated with a considerable cost-burden.