Ulcerative uremic stomatitis associated with untreated chronic renal failure: Report of a case and review of the literature

Demetrios Z. Antoniades DDS, MD, MSD, PhD , Anastasios K. Markopoulos DDS, MS, PhD , Demetrios Andreadis DDS, PhD , Ilias Balaskas MD , Eva Patrikalou MD , Demetrios Grekas MD, PhD
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Abstract

Uremic stomatitis represents a relatively uncommon intraoral complication seen, mostly, in cases of end-stage renal disease or undiagnosed/untreated chronic renal failure. Its incidence has decreased due to the advent of renal dialysis. Clinically uremic stomatitis is characterized by the presence of painful plaques and crusts that are usually distributed on the buccal mucosa, dorsal or ventral surface of the tongue, gingiva, lips, and floor of the mouth. Treatment consists of improvement of urea blood concentration and the underlying renal failure, supported by increased oral hygiene with antiseptic mouthwashes and antimicrobial/antifungal agents if necessary.

Although uremic stomatitis occurs in patients with end-stage renal disease, we report a case of a patient who exhibited an ulcerative form of uremic stomatitis related to the sudden relapse of uremia, although not in an advanced stage of her renal disease. A description of the clinical and microscopic appearance is given along with our hypothesis for the pathogenesis of the disease.

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溃疡性尿毒症性口炎合并未经治疗的慢性肾衰竭:1例报告及文献复习
尿毒症口炎是一种相对罕见的口腔内并发症,主要见于终末期肾脏疾病或未确诊/未经治疗的慢性肾衰竭。由于肾透析的出现,其发病率有所下降。临床上尿毒症性口炎的特征是存在疼痛的斑块和结痂,通常分布在颊黏膜、舌背或腹面、牙龈、嘴唇和口腔底。治疗包括改善尿素血浓度和潜在的肾衰竭,并辅以加强口腔卫生,必要时使用抗菌漱口水和抗菌/抗真菌药物。虽然尿毒症性口炎发生在终末期肾脏疾病的患者中,但我们报告了一例患者,她表现出溃疡形式的尿毒症性口炎,与尿毒症的突然复发有关,尽管不是在肾脏疾病的晚期。对临床和显微镜下的外观进行了描述,并给出了我们对疾病发病机制的假设。
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