Comparison of Oral Findings of Common Variable Immune Deficiency and Nephrotic Syndrome Patients with Hypogammaglobulinemia to Healthy Individuals

Abstract

Purpose: A group of disorders featuring lower serum immunoglobulin levels is called hypogammaglobulinemia. Being a primary immune disorder, Common variable immunodeficiency (CVID) is characterized by primary hypogammaglobulinemia. Nephrotic syndrome (NS) is an entity associated with secondary hypogammaglobulinemia. Lower concentrations of immunoglobulins in saliva may attenuate oral health. The aim of this study is to investigate the impact of salivary immunoglobulin concentrations on oral health in patients with primary and secondary hypogammaglobulinemia. Materials and methods: This study was a case-control study involving 19 CVID and 19 NS patients compared to 37 immunologically healthy individuals. Total saliva IgA, IgM and IgG levels, saliva microbiological parameters (total streptococci, mutans streptococci, lactobacilli, and total anaerobic bacteria counts), intraoral mucosal lesions, panoramic and bitewing radiographies, decayed, missing and filled teeth (DMFT), decayed, missing and filled surfaces (DMFS), plaque index, bleeding on probing (BOP) were analyzed. Results: The total concentrations of salivary IgG were statistically significant lower (p < 0.0001) in the case group. However, no such difference existed in total IgA and IgM levels. With regard to DMFT and DMFS indices, plaque index, or BOP, no major differences were found between the case and the control group. The mean colony-forming unit numbers of salivary lactobacilli, total streptococci, and anaerobic flora were significantly lower (p < 0.001) in the case group. Conclusion: Although the mean IgG level was lower among immunodeficient patients, the pathological oral data showed no significant difference. This may be explained by the least important effect of IgG on oral health compared to IgA and IgM.