The Incidences Of CD4~+T Lymphocytopenia And Infections In Patients With Bullous Pemphigoid

Objective:To explore the incidences of CD4~+T lymphocytopenia and infections in patients with bullous pemphigoid.Methods:We followed up 63 patients who received initial treatment in the First Hospital of China Medical University from 2011 March to 2016 August.The demographic information,disease course,direct and indirect immunofluorescence,anti-BP180 antibody,CD4~+T lymphocyte count,serum albumin value,treatment,hospitalization period,nosocomial infections,infections after discharge,recurrence and prognosis were recorded.Results:Among the 63 patients,26 were male and 37 were female.The mean age was72.2±11.1 years(range 40-93).The mean disease course was 1.9±2.1 months(range0.1-12).The CD4~+T lymphocyte count of 13 patients was less than 300/uL at admission,accounting for 20.63%.Systemic corticosteroids were applied in 60 cases,including 45cases combined with topical corticosteroids and 14 cases combined with immunosuppressants.Of the 13 BP patients with CL,5(38.46%)suffered from infections.The total rate of infections in 63 patients was 33.33%(21/63).In the 21patients,5 had CL.16 patients(25.40%)suffered from nosocomial infections,10patients(15.87%)suffered from infections after discharge,4 patients suffered from both nosocomial infections and post-dischage infections.Common infections were pneumonia 76.19%,urinary tract infection 19.05%,skin and soft tissue infection 14.29%.Four patients(19.05%)had bacteremia.The average age of patients with nosocomial infections was significantly higher than that of patients without nosocomial infections(P=0.026,t=-2.277).Stay in bed proportions of patients with or without post-dischage infections are statistically different.(P=0.029,x~2=5.752).Conclusion:The incidences of CL and infections were both high in patients with BP.The correlation between CL and infections is worth investigating further.Old age and immobilization were risk factors for the elevated incidence of infections in BP patients.