Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 7, 2015; 21(1): 229-232
Published online Jan 7, 2015. doi: 10.3748/wjg.v21.i1.229
Frequency and associated factors of hair loss among patients with inflammatory bowel disease
Rajesh Shah, Bincy Abraham, Jason Hou, Joseph Sellin
Rajesh Shah, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, United States
Bincy Abraham, Department of Medicine, Houston Methodist, Houston, TX 77030, United States
Jason Hou, Joseph Sellin, Division of Gastroenterology, Houston, TX 77030, United States
Author contributions: Shah R, Abraham B and Sellin J study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; Hou J and Sellin J analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; all authors read and approved the final manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Joseph Sellin, MD, Professor, Division of Gastroenterology, One Baylor Plaza Mail Stop 901, Houston, TX 77030, United States. sellin@bcm.edu
Telephone: +1-713-8733503 Fax: +1-713-8735305
Received: March 22, 2014
Peer-review started: March 23, 2014
First decision: April 15, 2014
Revised: May 2, 2014
Accepted: June 12, 2014
Article in press: June 13, 2014
Published online: January 7, 2015
Processing time: 291 Days and 4.4 Hours
Abstract

AIM: To identify the frequency of hair loss among patients with inflammatory bowel disease (IBD) and associated clinical and disease related factors.

METHODS: We performed a cross sectional study in a tertiary referral adult IBD clinic. Self-reported history and characteristics of hair loss as well as clinical and demographic information were collected. Data were analyzed using univariate and multivariate analyses.

RESULTS: Two hundred and ten consecutive IBD patients were recruited; one hundred and fifty patients met predefined inclusion and exclusion criteria. Thirty-three percent of patients reported a history of hair loss. Age, gender, IBD type and disease duration were not associated with hair loss. Hair loss was reported less frequently among patients with use of mesalamine (54% vs 73%, P = 0.03) and anti-tumor necrosis factor medications (anti-TNF) (14% vs 40%, P = 0.001). In multivariate analyses adjusting for gender, IBD type and duration of disease, these associations with mesalamine and anti-TNF remained significant [(adjusted values for mesalamine (OR = 0.43, 95%CI: 0.19-0.86) and anti-TNFs (OR = 0.28, 95%CI: 0.08-0.98)].

CONCLUSION: Hair loss is common among patients with IBD. Mesalamine and anti-TNF medications were associated with lower odds of hair loss. Further studies are required to assess the mechanism of hair loss among patients with IBD.

Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Alopecia

Core tip: Inflammatory bowel disease (IBD) is associated with several extra-intestinal manifestations, which can significantly impact a patient’s life. Anecdotally, patients have reported hair loss with medications to treat IBD, but no prior study has examined this association in depth. We report the results of a retrospective study showing hair loss to be common in patients with IBD and associated with mesalamine and infliximab use. These results suggest physicians should consider hair loss an EIM associated with IBD and specific medications might reduce the risk of hair loss.