주기성 호중구 감소증 환자의 구강 내 소견과 치료에 대한 증례 보고
ORAL FINDINGS AND TREATMENT OF A PATIENT WITH CYCLIC NEUTROPENIA
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주기성 호중구 감소증은 호중구의 수가 감소하였다가 다시 정상으로 회복되는 반응이 주기적으로 나타나는 혈액질환이다. 임상적 증상으로 발열, 실신, 두통 등이 있으며 구강 내 증상으로 동통성 연조직 궤양이 특징적인데 특히 입술, 혀, 협점막,치은이 흔하게 이환 된다. 또한, 치조골 파괴를 동반한 급진성 치주조직 상실을 보이기도 한다. 본 증례의 환아는 4세 1개월의 남아로서 잇몸이 붓고 이가 흔들린다는 것을 주소로 본과에 내원하였다. 환아는 주기성 호중구 감소증 환자로서 하악 전치부 5개 치아를 제외한 모든 유치에 우식이 있었으며 동요를 보이는 하악 좌∙우 제1유구치의국소적 치조골 소실을 확인할 수 있었다. 환아는 주기성 호중구 감소증에 기인한 광범위한 치아우식증, 치은염, 국소적 치주염으로 진단되었고 치료를 시행하였다. 주기성 호중구 감소증 환자에게는 정기적인 구강위생관리와 함께 치아우식, 치은염에 대한 시기적절한 치료가 필요하며 특히 어린 환자들에 있어서 영구치열 형성에 장애가 발생하지 않도록 조기에 개입을 하는 것이 중요하다.
Abstract
Cyclic neutropenia is a hematologic disorder characterized by a marked decrease in the number of circulating neutrophils occurring at regular intervals and after this period, the level of neutrophils usually recovers to a normal range. The clinical symptoms of cyclic neutropenia include fever, malaise, headaches and oral findings associated with painful soft tissue ulceration where lips, tongue and gingiva are typically involved. A 4 year 1 month old boy was presented to the hospital. His chief complaint was mobility of his teeth and swollen gums. The patient had suffered from cyclic neutropenia. Clinical examination revealed evident decay on all primary teeth except for the mandibular anterior teeth and localized alveolar bone loss around mandibullar right and left first primary molars which have mobility was notable. The patient was diagnosed with multiple dental caries, gingivitis and localized periodontitis associated with cyclic neutropenia and treated based on it. The dental treatment, including regular tooth care and appropriate treatment of dental caries or gingivitis, is essential for patients suffering cyclic neutropenia. Especially, proper care at an early stage is needed for young patients to minimize the unwanted consequences for permanent teeth development.
참고문헌 (18)
- Souid AK, "Congenital cyclic neutropenia", Clin Pediatr, 34, pp.151~155 (1995)
- Marcio A, "Early tooth loss due to cyclic neutropenia: long-term follow-up of one patient", SCD, 20, pp.187~190 (2000)
- Leale M, "Recurrent furunculosis in an infant showing an unusual blood picture", JAMA, 54, pp.1854~1855 (1910)
- Nakai Y, "Oral manifestations of cyclic nertropenia in a Japanese child: case report with a 5-year follow-up", Pediatr Dent, 25, pp.383~388 (2003)
- Pernu HE, "The importance of regular dental treatment in patients with cyclic neutropenia. Follow-up of 2 cases", J Periodontol, 67, pp.454~459 (1996)
- Prichard JF, "Prepubertal periodontitis affecting the deciduous and permanent dentition in a patient with cyclic neutropenia", J Periodontol, 55, pp.114~122 (1984)
- Spencer P, "Cyclic neutropenia: a literature review and report of case", J Dent Child, 52, pp.108~113 (1985)
- Binon PP, "Rehabilitative management of cyclic neutropenia", J Prosthet Dent, 31, pp.52~60 (1974)
- Guerry D, "Periodic hematopoiesis in human cyclic neutropenia", J Clin Invest, 52, pp.3220~3230 (1973)
- Dale DC, "A randomized controlled phase III trial of recombinant human granulocyte colony stimulating factor (filgrastim) for treatment of severe chronic neutropenia", Blood, 81, pp.2496~2502 (1993)
- Rami SK, "The colony-stimulating factors: use to prevent and treat neutropenia and its complications", Expert Opin Biol Ther, 4, pp.1897~1910 (2004)
- Ozer H, "2000 update of recommendations for the use of hematopoietic colony-stimulating factors: evidencebased, clinical practice guidelines", J Clin Oncol, 18, pp.3558~3585 (2000)
- David CD, "Cyclic Neutropenia", Semin Hematol, 39, pp.89~94 (2002)
- Matarasso S, "The Effect of Recombinant Granulocyte-Stimulating Factor on Oral and Periodontal Manifestation in a Patient with Cyclic Neutropenia: A Case Report", Int J Dent, pp.654239~ (2009)
- Mishkin DJ, "Congenital neutropenia. Report of a case and a biorationale for dental management", Oral Surg Oral Med Oral Pathol, 42, pp.738~745 (1976)
- American Academy of Pediatric Dentistry(AAPD), "Guideline on use of antibiotic therapy for patients at risk of infection: American Academy of Pediatric Dentistry(AAPD)", ~ (2007)
- American Academy of Pediatric Dentistry, "Clinical guideline on dental management of pediatric patients receiving chemotherpy, hematopoietic cell transplantation, and", or radiation, 2005, pp.27, 170~175
- Dalaney JE, "Pediatric oral pathology. Soft tissue and periodontal conditions", Pediatr Clin North Am, 47, pp.1125~1147 (2000)