• Shanthi Narla and Jonathan I Silverberg.
• Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
• J. Am. Acad. Dermatol. 2019 Feb 1; 80 (2): 382-389.

BackgroundLittle is known about the risk and predictors of autoimmune diseases in children and adults.ObjectiveTo determine the prevalence, predictors, and excess costs of autoimmune disease in atopic dermatitis (AD) patients.MethodsCross-sectional study of the 2002-2012 National Inpatient Sample, which includes a ∼20% sample of all US hospitalizations (n = 87,053,155 adults and children).ResultsThe prevalence of autoimmune disease was higher in adults with AD (7.9%, 95% confidence interval [95% CI] 7.3-8.5%) than without AD (5.7%, 95% CI 5.7%-5.8%) and higher in children with AD (2.0%, 95% CI 1.7%-2.3%) than without AD (1.0%, 95% CI 0.9%-1.1%). In multivariable logistic regression models controlling for sociodemographics, adult (adjusted odds ratio 1.45, 95% CI 1.32-1.58) and pediatric (adjusted odds ratio 2.08, 95% CI 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 13 of 24 examined in children, including disorders of the skin, endocrine, gastrointestinal, hematologic, and musculoskeletal systems. AD patients hospitalized with any autoimmune disorder had a higher cost of inpatient care, with $2.5-$50 million excess annual costs.ConclusionsAdults and children with AD had increased cutaneous and extracutaneous autoimmune disorders, which were associated with a considerable cost burden.Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

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