S1044 Prevalence of Vitiligo Among IBD and Celiac Disease Patients: Results From a Population-Based Study

Abstract

Introduction: Inflammatory bowel disease (IBD) is associated with skin manifestation; Erythema :odosum and pyoderma gangrenosum being the most common but other skin disorder have been reported in IBD. Vitiligo is a rare autoimmune disease that is diagnosed based on clinical findings and examining the skin by wood lamp that reveals depigmentation patches. In the past, case studies (Shafa S et al) and case reports have suggested a link between Vitiligo and IBD. Using a large database, we aim to describe the epidemiology and risk of Vitiligo in IBD patients. Methods: We used a multi-instituitional database (Explorys Inc, Cleveland, OH), an aggregate of electronic health record data from 26 US healthcare systems. In this database, we identified patients with a Systemized Nomenclature of Medicine Clinical Terms diagnosis of IBD, CD, and vitiligo from 1999 to the present. We assessed the association of vitiligo in IBD patients without CD and CD patients without IBD and compared them with individuals with neither IBD nor CD. Results: Out of the 70,383,890 patients in the database, we identified a total of 50,020 patients with vitiligo (0.1%), 412,950 patients with IBD (0.6%), and 136,690 patients with CD (0.2%). Among those with vitiligo, there were 450 (0.4%) CD patients (without IBD), 880 (0.3%) IBD patients (without CD), 50 (0.2%) patients with both celiac and IBD, and 48,640 (0.07%) patients with neither CD nor IBD (control group). The prevalence of vitiligo was 0.4% in celiac disease (without IBD) and 0.3% in IBD (without CD). The risk of vitiligo was higher in the CD-only group [OR 5.65 (5.15–6.20)] and IBD-only group [OR 3.24 (3.03–3.46)] compared to the control group (Table). In the IBD-only group, vitiligo was more commonly associated with females compared to males [OR 1.44 (1.19–1.74), P< 0.0001], in adults aged 18–65 compared to elderly patients [2.52 (2.08–3.06), P< 0.0001], and in Caucasians compared to non-Caucasians (OR 9.0 [7.25–11.17], P< 0.0001) (Figure). Conclusion: Utilizing a large population database, we report a distinct increased association of vitiligo in IBD and CD. Further studies are necessary to confirm this association and discover the mechanism behind this association.Figure 1.: Gender-, Age- and Race-Based Prevalence ratio of vitiligo in individuals with IBD without history of celiac disease in the United States. Table 1. - Odd’s ratio comparing the prevalence of vitiligo in celiac disease and in IBD to patients with vitiligo without celiac or IBD OR, 95% CI, p-value*Compared to patients with vitiligo without celiac nor IBD Vitiligo in Celiac disease (Excluding those with IBD) OR 5.65 (5.15-6.20), P< 0.0001 Vitiligo in IBD (Excluding those with celiac) OR 3.24 (3.03-3.46), P< 0.0001 Univariate analysis used to calculate OROR; odds ratio, CI; confidence interval, IBD; Inflammatory bowel disease.