Evaluation of the risk of venous thromboembolism in patients with bullous pemphigoid: a single-centre retrospective cohort study

Objective: Bullous pemphigoid (BP) is an autoimmune blistering disease that predominantly affects elderly individuals. It has been associated with various comorbidities, including neuropsychiatric disorders and diabetes mellitus. In patients with BP, elevated levels of prothrombin and D-dimer, as well as increased tissue factor expression, have been frequently observed, which may lead to endothelial activation. Its pathophysiology and predilection for older age may contribute to an increased risk of venous thromboembolism (VTE). Therefore, in this study, we aimed to retrospectively investigate the clinical characteristics, survival, frequency of VTE, and its impact on survival in patients diagnosed with BP. Methods: In this study, the clinical characteristics, survival duration, VTE incidence, and its impact on survival were retrospectively evaluated in patients who presented to Zonguldak Bülent Ecevit University between 2010-2024 and had a clinical and histopathological diagnosis of BP. Results: A total of 53 patients (37 female, 16 male) were included in the study. The mean age at diagnosis was 75.15 years (± 9.7). The most common comorbidities were diabetes mellitus (n=35) and hypertension (n=30). The median survival time was estimated at 39 months according to survival analysis. VTE was observed in 3 patients (5.7%). The incidence rate of VTE in BP patients was 42.6 per 1,000 person-years. The incidence rate of VTE in BP was found to be statistically significantly higher compared with the incidence rate of VTE in the population over 18 years of age and in the elderly population in population-based studies (p