Sickle cell crisis precipitated by periodontal infection: report of two cases

Rada, Robert E.; Bronny, Andrew T.; Hasiakos, Peter.

doi:10.14219/jada.archive.1987.0173

Cited by 30 publications

(36 citation statements)

References 7 publications

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“…Sickle cell crises show varying severity and frequency and may be precipitated by dehydration, acidosis, trauma, strenuous exercise, surgery, infections, vascular occlusion, and pulmonary disease. [3][4][5] They are accompanied by joint, muscle, abdominal, chest, and bone pain, possibly low-grade fever, and fatigue and weakness, lasting from a few hours to some weeks. 3 Other clinical manifestations apart from the vasoocclusive complications resulting from micro-and macroinfarctions of body tissues include impaired growth and development, increased susceptibility to infection, and chronic anemia from both hemolysis of the sickle cells and aplastic bone marrow.…”

Section: Introductionmentioning

confidence: 99%

Mandibular lesions of vasoocclusive origin in sickle cell hemoglobinopathy

Kavadia-Tsatala

Kolokytha

Kaklamanos³

et al. 2004

Odontology

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Sickle cell hemoglobinopathy is an inherited disorder characterized by vasoocclusive crises. Involvement of the maxillofacial skeleton leading to radiopaque lesions that correspond to bone infarcts has rarely been reported in the literature. Forty-two adult patients suffering from sickle cell anemia were examined radiographically for radiopaque lesions situated in the course of a known vessel or in the apical region of the teeth. In 6 cases, such lesions were combined with facial pain during sickle cell crisis and absence of dental pathology and were considered to be of possible vasoocclusive origin. In conclusion, vasoocclusive involvement should be taken into consideration when assessing painful episodes or neurological symptoms in the maxillofacial region in this patient population.

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Section: Introductionmentioning

confidence: 99%

Mandibular lesions of vasoocclusive origin in sickle cell hemoglobinopathy

Kavadia-Tsatala

Kolokytha

Kaklamanos³

et al. 2004

Odontology

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“…Oral problems, including unilateral infarct of the mandible [59,60], pulpal necrosis [59,61], osteonecrosis [62], facial swelling [63], diastema and hypodontia [64], gingival enlargement [63], palatal pallor [65], increased risk for caries [66], osteomyelitis of the mandible [67], unilateral anesthesia [60,62], midfacial overgrowth [65], and orofacial pain [65,67,68], have been reported [69]. As iNOS activity and expression are strongly correlated with immune and inflammatory systems, to eliminate the likelihood of conflicting results in the present study only participants that were free of clinically detectable infection and inflammation were included; the participants had no ongoing dental, periodontal, or orofacial disorders.…”

Section: Discussionmentioning

confidence: 99%

Nitric oxide in gingival crevicular fluid and nitric oxide synthase expression in the gingiva of patients with sickle cell disease

Güzeldemir

Toygar²,

Bal³

et al. 2011

Turk J Hematol

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Objective: This study aimed to biochemically measure the production of nitric oxide in gingival crevicular fluid and immunohistochemically measure the expression of inducible nitric oxide synthase in the gingiva of patients with sickle cell disease. Additionally, we aimed to obtain insight into the immunopathology of sickle cell disease by comparing inducible nitric oxide synthase levels in patients with sickle cell disease and controls using gingiva and gingival crevicular fluid. Materials and Methods: The study included 20 sickle cell disease patients and 20 healthy controls. Immunohistochemical analysis was used to measure inducible nitric oxide synthase expression in gingiva and nitric oxide levels in gingival crevicular fluid were spectrophotometrically measured. Results: Nitric oxide levels in the patients and controls did not differ significantly (21.2±4.5 and 23.1±2.3 μM L -1 , respectively, p>0.05). There weren't any statistically significant differences in infiltrated inflammatory cells, density of inflammatory cells that stained with inducible nitric oxide synthase, or nitric oxide expression in gingiva between the patient and control groups (p>0.05). Conclusion: To the best of our knowledge this is the first study to examine the expression of inducible nitric oxide synthase in the gingiva and gingival crevicular fluid in patients with sickle cell disease. Using the gingiva and gingival crevicular fluid we were unable to observe sickle cell disease-associated inducible nitric oxide synthase expression and a difference in nitric oxide levels.

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“…If proper treatment is not adopted, gingivitis can proceed to have serious complications such as chronic peritonitis, dental abscess, and bone destruction culminating in tooth loss [40]. Periodontal infection may precipitate painful vaso-occlusive crises and increase the frequency of hospital admissions among adult SCD patients [41,42].…”

Section: Infectionmentioning

confidence: 99%