未确诊的常见可变免疫缺陷引起的口腔手术并发症1例。

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Oral and Maxillofacial Surgery-Heidelberg Pub Date : 2024-12-12 DOI:10.1007/s10006-024-01310-6
Eleazar Mezaiko, Lucas Teixeira Brito, Barbara Luiza de Britto Cançado, Weldes Francisco da Silva Junior, Fernanda Paula Yamamoto-Silva, Brunno Santos de Freitas Silva
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引用次数: 0

摘要

目的:本报告旨在介绍一种跨学科的方法来诊断和治疗一例先天性免疫缺陷(CVID),这是一种先天性免疫错误,导致第三磨牙拔牙手术后的连续并发症。病例介绍:患者,一位37岁的白人女性,寻求专家拔除与含牙囊肿相关的阻生下第三磨牙。由于下颌骨折的可能性,在该区域使用了骨固定系统。然而,尽管进行了各种治疗和住院治疗,她在手术后仍出现复发性感染,这些感染无法用任何因素解释。CVID的诊断是通过排除因素、低免疫球蛋白水平和免疫学家的综合过敏评估来确定的。只有在拆除固定系统并每月进行免疫球蛋白输注后,患者的病情才得以缓解并出院。结论:CVID通常诊断较晚,导致重大的经济、社会和健康负担,包括反复住院、过敏和恶性肿瘤风险增加。本病例强调了在口腔颌面外科手术后出现不明原因复发感染的患者考虑CVID的重要性。此外,它强调了有效管理CVID患者的多学科方法的必要性。
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Oral surgery complication resulting from undiagnosed common variable immunodeficiency: a case report.

Purpose: This report aims to present an interdisciplinary approach to diagnosing and treating a case of Common Variable Immunodeficiency (CVID), an inborn error of immunity, resulting in successive complications following a third molar extraction procedure.

Case presentation: The patient, a 37-year-old Caucasian female, sought a specialist for the extraction of an impacted lower third molar associated with dentigerous cyst. Due to the possibility of mandibular fracture, a bone fixation system was used in the region. However, she experienced recurrent infections following the procedure despite various treatments and hospitalizations, and these infections could not be explained by any factors. The diagnosis of CVID was established through exclusionary factors, low immunoglobulin levels, and comprehensive allergy assessments by an immunologist. Resolution of the patient's condition and discharge were achieved only after removing the fixation system and implementing monthly immunoglobulin infusions.

Conclusion: CVID is often diagnosed late, resulting in significant economic, social, and health burdens, including recurrent hospitalizations, allergies, and increased risk of malignancy. This case underscores the importance of considering CVID in patients presenting with unexplained recurrent infections following oral and maxillofacial surgeries. Additionally, it highlights the necessity of a multidisciplinary approach for effectively managing patients with CVID.

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来源期刊
Oral and Maxillofacial Surgery-Heidelberg
Oral and Maxillofacial Surgery-Heidelberg DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.20
自引率
5.60%
发文量
118
期刊介绍: Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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