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Aggressive periodontitis associated with Fanconi's anemia. A case report
H Nowzari1, M G Jorgensen, T T Ta
1University of Southern California School of Dentistry, Los Angeles, USA.
Journal of Periodontology
|January 5, 2002
Summary
Fanconi's anemia patients may experience severe periodontitis due to impaired immunity and infections like human cytomegalovirus (HCMV) and Actinobacillus actinomycetemcomitans. This highlights the importance of monitoring oral health in these individuals.
Area of Science:
- Oral Medicine
- Periodontology
- Infectious Diseases
Background:
- Fanconi's anemia (FA) is a rare genetic disorder characterized by bone marrow failure, chromosomal instability, and increased cancer risk.
- FA patients exhibit pancytopenia, developmental abnormalities, and heightened susceptibility to infections.
- This study investigates the oral health and microbial status in an 11-year-old male with Fanconi's anemia.
Observation:
- The patient presented with pancytopenia, asthma, and developmental impairments, alongside severe gingival inflammation and periodontal attachment loss.
- Dental examination revealed significant gingivitis and periodontitis in the erupted permanent teeth.
- Polymerase chain reaction detected human cytomegalovirus (HCMV) and herpes simplex virus (HSV) in periodontal samples, with HCMV mRNA indicating active infection.
Findings:
- The periodontitis sample yielded HCMV and HSV genomes, and HCMV mRNA, suggesting active viral infection.
- Bacterial analysis of the periodontitis sample identified Actinobacillus actinomycetemcomitans, Fusobacterium species, Campylobacter species, Peptostreptococcus micros, and Candida albicans.
- HCMV and A. actinomycetemcomitans were implicated as potential contributors to severe periodontitis in FA patients.
Implications:
- Fanconi's anemia patients exhibit increased susceptibility to severe periodontitis.
- Compromised host defense mechanisms in FA likely exacerbate periodontal infections.
- Integrated oral care and monitoring are crucial for managing periodontitis in individuals with Fanconi's anemia.