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Wang T, Tang Z, Xiao T, Ren J, He S, Liu Y, Xiao S, Wang X. Identification of a novel compound heterozygous mutation and a homozygous mutation of SLURP1 in Chinese families with Mal de Meleda. BMC Med Genomics 2023; 16:152. [PMID: 37393290 PMCID: PMC10314434 DOI: 10.1186/s12920-023-01580-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 06/13/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Mal de Meleda is an autosomal recessive palmoplantar keratoderma, with SLURP1 identified as the pathogenic gene responsible. Although over 20 mutations in SLURP1 have been reported, only the mutation c.256G > A (p.G87R) has been detected in Chinese patients. Here, we report a novel heterozygous SLURP1 mutation in a Chinese family. METHODS We assessed the clinical manifestations of two Chinese patients with Mal de Meleda and collected specimens from the patients and other family members for whole-exome and Sanger sequencing. We used algorithms (MutationTaster, SIFT, PolyPhen-2, PROVEAN, PANTHER, FATHMM, mCSM, SDM and DUET) to predict the pathogenetic potential of the mutation detected. We also employed AlphaFold2 and PyMOL for protein structure analysis. RESULTS Both patients displayed the typical manifestation of palmoplantar keratoderma. In Proband 1, we detected a novel compound heterozygous mutation (c.243C > A and c.256G > A) in exon 3 of SLURP1. Proband 2 was an adult female born to a consanguineous family and carried a homozygous mutation (c.211C > T). Algorithms indicated both mutations to be probably disease causing. We used AlphaFold2 to predict the protein structure of these mutations and found that they cause instability, as shown by PyMOL. CONCLUSIONS Our study identified a novel compound heterozygous mutation (c.243C > A and c.256G > A) in a Chinese patient with Mal de Meleda that has the potential to cause instability in protein structure. Moreover, this study expands on the existing knowledge of SLURP1 mutations and contributes to knowledge of Mal de Meleda.
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Affiliation(s)
- Tian Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Zhuangli Tang
- Department of Dermatology, The Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Tong Xiao
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Junru Ren
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Shuyao He
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Yan Liu
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China
| | - Shengxiang Xiao
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China.
| | - Xiaopeng Wang
- Department of Dermatology, The Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwu Road, Xi'an, 710004, China.
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Luong A, Tawfik AN, Islamoglu H, Gobriel HS, Ali N, Ansari P, Shah R, Hung T, Patel T, Henson B, Thankam F, Lewis J, Mintline M, Boehm T, Tumur Z, Seleem D. Periodontitis and diabetes mellitus co-morbidity: A molecular dialogue. J Oral Biosci 2021; 63:360-369. [PMID: 34728373 DOI: 10.1016/j.job.2021.10.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) and periodontitis are two biologically linked diseases that often coexist in complex interaction. While periodontitis may lead to insulin receptor desensitization, diabetes may increase the expression of inflammatory cytokines, such as Tumor Necrosis Factor-α (TNF-α) and Interleukin 6 (IL-6), in the gingival crevicular fluid and activate osteoclasts via Receptor activator of nuclear factor kappa-Β ligand (RANK-L) production, leading to bone resorption. However, the association between the two diseases processes, where one may exacerbate the progression of the other, is unclear. In addition, both diseases have similar mechanistic themes, such as chronic inflammation and oxidative stress. This review aimed to investigate the pathophysiological and molecular mechanisms underlying T2DM and periodontitis. HIGHLIGHT Uncontrolled diabetes is often associated with severe periodontitis, measured by clinical attachment loss. Alteration in the oral microbiome composition, which may activate the host inflammatory response and lead to irreversible oxidative stress, is a common finding in both diseases. An understanding of the molecular crosstalk between the two disease processes is crucial for developing therapeutic targets that inhibit bone resorption and halt the progression of periodontitis in patients with diabetes. CONCLUSION The Oral microbiome composition in T2DM and periodontitis shifts toward dysbiosis, favoring bacterial pathogens, such as Fusobacteria and Porphyromonas species. Both conditions are marked by pro-inflammatory immune activity via the activation of Interleukin 17 (IL-17), Interleukin 1 (IL-1), TNF-α, and Nuclear Factor Kappa Beta (NF-κB). Common molecular crosstalk signaling appears to involve advanced glycation end products (AGEs) and oxidative stress. Thus, future drug targets are multifactorial, ranging from modulatory of host inflammatory response to preventing the accumulation of AGEs and oxidative free radicals.
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Affiliation(s)
- Anthony Luong
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Andy Nassif Tawfik
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Hicret Islamoglu
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Hanaa Selim Gobriel
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Nada Ali
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Pouya Ansari
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Ruchita Shah
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Tiffany Hung
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Tanusha Patel
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Bradley Henson
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Finosh Thankam
- College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Jill Lewis
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Mark Mintline
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Tobias Boehm
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Zohra Tumur
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA
| | - Dalia Seleem
- College of Dental Medicine, Western University of Health Sciences, Pomona, CA 91766-1854, USA.
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3
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Adamski Z, Burchardt D, Pawlaczyk-Kamieńska T, Borysewicz-Lewicka M, Wyganowska-Świątkowska M. Diagnosis of Papillon-Lefèvre syndrome: review of the literature and a case report. Postepy Dermatol Alergol 2020; 37:671-676. [PMID: 33240004 PMCID: PMC7675075 DOI: 10.5114/ada.2020.100480] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/06/2019] [Indexed: 11/17/2022] Open
Abstract
Papillon-Lefëvre syndrome (PLS), classified as ectodermal dysplasia, is an autosomal recessive condition related to the cathepsin C (CTSC) gene mutation. The first clinical symptoms, occurring most commonly between the ages of 1 and 4, are palmoplantar hyperkeratosis and also periodontitis resulting in the loss of most or all teeth in the same sequence in which they erupted. Most often the redness of palms and soles precede the occurrence of keratoderma. Moreover, excessive sweating, moderate mental retardation, the tendency to purulent skin and internal organs infection may occur. Lack of cathepsin seems to have a crucial role in the intensity of symptoms. In most of the patients, there can be observed impairment of phagocytosis and chemotaxis of neutrophils, granulocytes, leukocytes and cytotoxic lesion of fibroblasts and macrophages. Also, functional impairment of lymphocytes, neutrophils, and monocytes is observed. The study, using flow cytometry, showed a decreased percentage of T cells CD8+ and increased CD4:CD8 ratio.
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Affiliation(s)
- Zygmunt Adamski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| | - Dorota Burchardt
- Department of Paediatric Dentistry, Poznan University of Medical Sciences, Poznan, Poland
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4
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Pap ÉM, Farkas K, Tóth L, Fábos B, Széll M, Németh G, Nagy N. Identification of putative genetic modifying factors that influence the development of Papillon-Lefévre or Haim-Munk syndrome phenotypes. Clin Exp Dermatol 2020; 45:555-559. [PMID: 31925812 DOI: 10.1111/ced.14171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Papillon-Lefévre syndrome (PLS; OMIM 245000) and Haim-Munk syndrome (HMS; OMIM 245010), which are both characterized by palmoplantar hyperkeratosis and periodontitis, are phenotypic variants of the same disease caused by mutations of the cathepsin C (CTSC) gene. AIM To identify putative genetic modifying factors responsible for the differential development of the PLS or HMS phenotypes, we investigated two Hungarian patients with different phenotypic variants (PLS and HMS) but carrying the same homozygous nonsense CTSC mutation (c.748C/T; p.Arg250X). METHODS To gain insights into phenotype-modifying associations, whole exome sequencing (WES) was performed for both patients, and the results were compared to identify potentially relevant genetic modifying factors. RESULTS WES revealed two putative phenotype-modifying variants: (i) a missense mutation (rs34608771) of the SH2 domain containing 4A (SH2D4A) gene encoding an adaptor protein involved in intracellular signalling of cystatin F, a known inhibitor of the cathepsin protein, and (ii) a missense variant (rs55695858) of the odorant binding protein 2A (OBP2A) gene, influencing the function of the cathepsin protein through the glycosyltransferase 6 domain containing 1 (GLT6D1) protein. CONCLUSION Our study contributes to the accumulating evidence supporting the clinical importance of phenotype-modifying genetic factors, which have high potential to aid the elucidation of genotype-phenotype correlations and disease prognosis.
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Affiliation(s)
- É M Pap
- Department of Obstetrics and Gynecology Szeged, University of Szeged, Szeged, Hungary
| | - K Farkas
- Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - L Tóth
- Department of Medical Genetics, University of Szeged, Szeged, Hungary
| | - B Fábos
- Mór Kaposi Teaching Hospital, Kaposvár, Hungary
| | - M Széll
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
| | - G Németh
- Department of Obstetrics and Gynecology Szeged, University of Szeged, Szeged, Hungary
| | - N Nagy
- Department of Medical Genetics, University of Szeged, Szeged, Hungary.,Dermatological Research Group of the Hungarian Academy of Sciences, University of Szeged, Szeged, Hungary
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5
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Silva LM, Brenchley L, Moutsopoulos NM. Primary immunodeficiencies reveal the essential role of tissue neutrophils in periodontitis. Immunol Rev 2019; 287:226-235. [PMID: 30565245 DOI: 10.1111/imr.12724] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 10/06/2018] [Indexed: 12/14/2022]
Abstract
Periodontitis is a common human inflammatory disease. In this condition, microbiota trigger excessive inflammation in oral mucosal tissues surrounding the dentition, resulting in destruction of tooth-supporting structures (connective tissue and bone). While susceptibility factors for common forms of periodontitis are not clearly understood, studies in patients with single genetic defects reveal a critical role for tissue neutrophils in disease susceptibility. Indeed, various genetic defects in the development, egress from the bone marrow, chemotaxis, and extravasation are clearly linked to aggressive/severe periodontitis at an early age. Here, we provide an overview of genetic defects in neutrophil biology that are linked to periodontitis. In particular, we focus on the mechanisms underlying Leukocyte Adhesion Deficiency-I, the prototypic Mendelian defect of impaired neutrophil extravasation and severe periodontitis.
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Affiliation(s)
- Lakmali M Silva
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, Maryland.,Proteases and Remodeling Section, NIDCR, NIH, Bethesda, Maryland
| | - Laurie Brenchley
- Oral Immunity and Inflammation Unit, NIDCR, NIH, Bethesda, Maryland
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6
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Papillon-Lefèvre Syndrome: Diagnosis, Dental Management, and a Case Report. Case Rep Dent 2019; 2019:4210347. [PMID: 31179131 PMCID: PMC6501246 DOI: 10.1155/2019/4210347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/03/2019] [Indexed: 11/18/2022] Open
Abstract
Aim This paper revisits Papillon-Lefèvre syndrome (PLS), addresses its diagnostic update and dental management, and reports a case of a 5-year-old Lebanese patient with consanguineously married parents. Background PLS, also known as “keratoris palmoplantaris with periodontopathia” and “hyperkeratosis palmoplantaris with periodontosis,” is an extremely rare autosomal-recessive trait that combines a diffuse palmoplantar hyperkeratosis and a severe generalized, progressive prepubertal form of a precocious form of juvenile, aggressive periodontitis. Case Description We are reporting a 5-year-old boy that sustained a spontaneous loss of all his primary teeth. At consultation, he was under treatment for hyperkeratosis of his palms and soles. Detailed family history of the child revealed that the patient's parents, grandparents, and relatives were consanguineously married and two of his cousins displayed similar clinical signs (palmoplantar hyperkeratosis and premature loss of deciduous and most of the permanent teeth). Conclusion PLS is an extremely rare disorder that usually becomes apparent from approximately 1-5 years of age. Genetic counseling should always be suggested to parents of affected children, informing them of chances of their offspring having the inherited disease.
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7
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Korkmaz B, Caughey GH, Chapple I, Gauthier F, Hirschfeld J, Jenne DE, Kettritz R, Lalmanach G, Lamort AS, Lauritzen C, Łȩgowska M, Lesner A, Marchand-Adam S, McKaig SJ, Moss C, Pedersen J, Roberts H, Schreiber A, Seren S, Thakker NS. Therapeutic targeting of cathepsin C: from pathophysiology to treatment. Pharmacol Ther 2018; 190:202-236. [DOI: 10.1016/j.pharmthera.2018.05.011] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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8
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Palmér R, Mäenpää J, Jauhiainen A, Larsson B, Mo J, Russell M, Root J, Prothon S, Chialda L, Forte P, Egelrud T, Stenvall K, Gardiner P. Dipeptidyl Peptidase 1 Inhibitor AZD7986 Induces a Sustained, Exposure-Dependent Reduction in Neutrophil Elastase Activity in Healthy Subjects. Clin Pharmacol Ther 2018; 104:1155-1164. [PMID: 29484635 PMCID: PMC6282495 DOI: 10.1002/cpt.1053] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 02/16/2018] [Accepted: 02/19/2018] [Indexed: 11/30/2022]
Abstract
Neutrophil serine proteases (NSPs), such as neutrophil elastase (NE), are activated by dipeptidyl peptidase 1 (DPP1) during neutrophil maturation. High NSP levels can be detrimental, particularly in lung tissue, and inhibition of NSPs is therefore an interesting therapeutic opportunity in multiple lung diseases, including chronic obstructive pulmonary disease (COPD) and bronchiectasis. We conducted a randomized, placebo‐controlled, first‐in‐human study to assess the safety, tolerability, pharmacokinetics, and pharmacodynamics of single and multiple oral doses of the DPP1 inhibitor AZD7986 in healthy subjects. Pharmacokinetic and pharmacodynamic data were analyzed using nonlinear mixed effects modeling and showed that AZD7986 inhibits whole blood NE activity in an exposure‐dependent, indirect manner—consistent with in vitro and preclinical predictions. Several dose‐dependent, possibly DPP1‐related, nonserious skin findings were observed, but these were not considered to prevent further clinical development. Overall, the study results provided confidence to progress AZD7986 to phase II and supported selection of a clinically relevant dose.
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Affiliation(s)
- Robert Palmér
- Quantitative Clinical Pharmacology, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Jukka Mäenpää
- Patient Safety, Respiratory, Inflammation, Autoimmunity, Infections and Vaccines Therapeutic Area, AstraZeneca, Gothenburg, Sweden
| | - Alexandra Jauhiainen
- Early Clinical Biometrics, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Bengt Larsson
- RIA Translational Medicines Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - John Mo
- Translational Biology, Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Muir Russell
- Precision Medicine Laboratories, Precision Medicine and Genomics, IMED Biotech Unit, AstraZeneca, Cambridge, UK
| | - James Root
- Bioscience, Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Susanne Prothon
- Quantitative Clinical Pharmacology, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Ligia Chialda
- Parexel Early Phase Clinical Unit, Harrow, London, UK
| | - Pablo Forte
- Parexel Early Phase Clinical Unit, Harrow, London, UK
| | | | - Kristina Stenvall
- Respiratory, Inflammation and Autoimmunity, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
| | - Philip Gardiner
- Quantitative Clinical Pharmacology, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, Sweden
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9
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Sharma D, Jindal AK, Rawat A, Singh S. Approach to a Child with Primary Immunodeficiency Made Simple. Indian Dermatol Online J 2017; 8:391-405. [PMID: 29204384 PMCID: PMC5707833 DOI: 10.4103/idoj.idoj_189_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primary immunodeficiency disorders (PIDs) are a group of disorders affecting the capability to fight against infection. These include defects in T cells and B cells affecting cell-mediated and humoral immunity, respectively, combined humoral and cell-mediated immunodeficiency, defects in phagocytosis, complement defects, and defects in cytokine or cytokine signalling pathways which are detrimental for immune function. Depending upon the type and severity, age at onset of symptoms can vary from neonatal period to late childhood. Clinically, this group of disorders can involve any organ system of an individual such as respiratory system, gastrointestinal system, skin and mucous membrane, bone and joints, endocrine organs, and nervous system. Common dermatological manifestations include eczema, warts, molluscum contagiosum, mucocutaneous candidiasis, recurrent nonhealing ulcers, skin abscesses, erythroderma, petechiae, and nail changes. The common skin manifestations of various PIDs include eczema (seen in Wiskott-Aldrich syndrome and autosomal dominant hyper IgE syndrome); erythroderma (in Omen syndrome); viral warts or molluscum contagiosum (in autosomal recessive hyper IgE syndrome); chronic mucocutaneous candidiasis (in hyper IgE syndrome, autoimmune polyendocrinopathy candidiasis ectodermal dysplasia syndrome, Th17 cell defects); recurrent nonhealing ulcers (in leucocyte adhesion defect); skin abscesses (in antibody defects, hyper IgE syndrome, and chronic granulomatous disease); petechial or purpuric spots (in Wiskott-Aldrich syndrome).
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Affiliation(s)
- Dhrubajyoti Sharma
- Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur K. Jindal
- Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Rawat
- Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surjit Singh
- Allergy Immunology Unit, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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10
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Peacock ME, Arce RM, Cutler CW. Periodontal and other oral manifestations of immunodeficiency diseases. Oral Dis 2017; 23:866-888. [PMID: 27630012 PMCID: PMC5352551 DOI: 10.1111/odi.12584] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/31/2016] [Accepted: 09/08/2016] [Indexed: 12/14/2022]
Abstract
The list of immunodeficiency diseases grows each year as novel disorders are discovered, classified, and sometimes reclassified due to our ever-increasing knowledge of immune system function. Although the number of patients with secondary immunodeficiencies (SIDs) greatly exceeds those with primary immunodeficiencies (PIDs), the prevalence of both appears to be on the rise probably because of scientific breakthroughs that facilitate earlier and more accurate diagnosis. Primary immunodeficiencies in adults are not as rare as once thought. Globally, the main causes of secondary immunodeficiency are HIV infection and nutritional insufficiencies. Persons with acquired immune disorders such as AIDS caused by the human immunodeficiency virus (HIV) are now living long and fulfilling lives as a result of highly active antiretroviral therapy (HAART). Irrespective of whether the patient's immune-deficient state is a consequence of a genetic defect or is secondary in nature, dental and medical practitioners must be aware of the constant potential for infections and/or expressions of autoimmunity in these individuals. The purpose of this review was to study the most common conditions resulting from primary and secondary immunodeficiency states, how they are classified, and the detrimental manifestations of these disorders on the periodontal and oral tissues.
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Affiliation(s)
- Mark E Peacock
- Associate Professor, Departments of Periodontics, Oral Biology
| | - Roger M. Arce
- Assistant Professor, Departments of Periodontics, Oral Biology
| | - Christopher W Cutler
- Professor, Departments of Periodontics, Oral Biology; Chair, Department of Periodontics, Associate Dean for Research, The Dental College of Georgia at Augusta University
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11
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Ocular Surface Squamous Neoplasia in Papillon-Lefèvre Syndrome: Outcome at Long-Term Follow-Up of 12 Years. Cornea 2017; 36:743-746. [PMID: 28350623 DOI: 10.1097/ico.0000000000001179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To discuss the association between ocular surface squamous neoplasia (OSSN) and Papillon-Lefèvre syndrome (PLS) and present the long-term outcome in a patient with these diseases. METHODS Case report. RESULTS A 14-year-old boy presented with a raised pigmented mass lesion at the limbus in the right eye, which was clinically suggestive of OSSN. He also had palmoplantar hyperkeratosis and periodontosis suggestive of PLS. Excision biopsy of the lesion confirmed the diagnosis of OSSN. He was free of tumor recurrence for 2 years and was lost to follow-up thereafter. Seven years later, the patient presented with diffuse tumor recurrence with orbital extension in the right eye, regional lymph node metastasis, and ipsilateral parotid gland infiltration. The patient underwent exenteration of the right orbital contents, right parotidectomy, and radical neck dissection followed by concomitant external beam radiotherapy and systemic chemotherapy. Eleven years from initial presentation, the patient was detected to have OSSN in the contralateral eye and was managed by wide excision biopsy and adjuvant cryotherapy. One year after detection of OSSN in the left eye, the patient was found to have systemic metastases to the lungs and brain. The patient died of the disease within 3 months of detection of systemic metastasis. CONCLUSIONS OSSN in PLS is associated with poor prognosis.
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12
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AIBarrak ZM, Alqarni AS, Chalisserry EP, Anil S. Papillon-Lefèvre syndrome: a series of five cases among siblings. J Med Case Rep 2016; 10:260. [PMID: 27658951 PMCID: PMC5034476 DOI: 10.1186/s13256-016-1051-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Accepted: 09/01/2016] [Indexed: 11/12/2022] Open
Abstract
Background Papillon–Lefèvre syndrome is a rare autosomal recessive disorder characterized by palmoplantar hyperkeratosis and aggressively progressing periodontitis leading to premature loss of deciduous and permanent dentition. The etiopathogenesis of the syndrome is relatively obscure, and immunologic, genetic, or possible bacterial etiologies have been proposed. Case presentation A series of five cases of Papillon–Lefèvre syndrome among the siblings in a family is presented here: a 3-year-old Arab girl, a 4-year-old Arab boy, a 11-year-old Arab boy, a 12-year-old Arab boy, and a 14-year-old Arab boy. The patients presented with severe gingival inflammation and mobility of teeth. The clinical manifestations were typical of Papillon–Lefèvre syndrome and the degree of involvement of the oral and skin conditions varied among them. Conclusions This case series stresses the consanguinity in the family as an etiologic factor. All siblings in the family were affected with Papillon–Lefèvre syndrome which makes this a rare case. A multidisciplinary approach with the active participation of a dental surgeon, dermatologist, and pediatrician is essential for the management of cases of Papillon–Lefèvre syndrome.
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Affiliation(s)
- Zyad M AIBarrak
- King Abdulaziz Medical City, Ministry of Health, Riyadh, Saudi Arabia.
| | - Adel S Alqarni
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, 153, AIkharj, 11942, Riyadh, Saudi Arabia
| | - Elna P Chalisserry
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, 82943, Saudi Arabia
| | - Sukumaran Anil
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdulaziz University, 153, AIkharj, 11942, Riyadh, Saudi Arabia
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13
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Nicu EA, Loos BG. Polymorphonuclear neutrophils in periodontitis and their possible modulation as a therapeutic approach. Periodontol 2000 2016; 71:140-63. [DOI: 10.1111/prd.12113] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2015] [Indexed: 12/24/2022]
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14
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Khocht A, Albandar JM. Aggressive forms of periodontitis secondary to systemic disorders. Periodontol 2000 2015; 65:134-48. [PMID: 24738590 DOI: 10.1111/prd.12015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
A number of systemic disorders increase a patient's susceptibility to destructive periodontitis and have impacts on periodontal disease progression and severity. The underlying factors are usually genetic and are mainly related to alterations in the immune response and in certain endocrine functions, leading to various syndromes in which periodontitis and/or early tooth loss are secondary manifestations. Neutrophils are important immune defense cells that play a significant role in controlling the spread of microbial plaque infections in the dentogingival region. This review focuses on a selected group of systemic disorders that are associated with alterations in either neutrophil counts (quantitative disorders) or function (qualitative disorders), and defects in the mineralization of bone and dental tissues. In most of these diseases controlling the periodontal disease progression is very challenging. Proper diagnosis is a prerequisite for proper management of the periodontal problem. Future advances in research, including gene targeting and the resolution of enzyme deficiencies, may bring about remedies of the underlying systemic disorders and may significantly improve the outcome of periodontal treatment in these patients.
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Sulák A, Tóth L, Farkas K, Tripolszki K, Fábos B, Kemény L, Vályi P, Nagy K, Nagy N, Széll M. One mutation, two phenotypes: a single nonsense mutation of theCTSCgene causes two clinically distinct phenotypes. Clin Exp Dermatol 2015. [DOI: 10.1111/ced.12710] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A. Sulák
- Department of Medical Genetics; University of Szeged; Szeged Hungary
| | - L. Tóth
- Department of Medical Genetics; University of Szeged; Szeged Hungary
| | - K. Farkas
- MTA SZTE Dermatological Research Group; University of Szeged; Szeged Hungary
| | - K. Tripolszki
- Department of Medical Genetics; University of Szeged; Szeged Hungary
| | - B. Fábos
- Mór Kaposi Teaching Hospital; Kaposvár Hungary
| | - L. Kemény
- MTA SZTE Dermatological Research Group; University of Szeged; Szeged Hungary
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - P. Vályi
- Department of Parodontology; Faculty of Dentistry; University of Szeged; Szeged Hungary
| | - K. Nagy
- Department of Parodontology; Faculty of Dentistry; University of Szeged; Szeged Hungary
| | - N. Nagy
- Department of Medical Genetics; University of Szeged; Szeged Hungary
- MTA SZTE Dermatological Research Group; University of Szeged; Szeged Hungary
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - M. Széll
- Department of Medical Genetics; University of Szeged; Szeged Hungary
- MTA SZTE Dermatological Research Group; University of Szeged; Szeged Hungary
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Papillion-Lefèvre Syndrome: Periodontists’ Perspective. Case Rep Dent 2015; 2015:137381. [PMID: 26523234 PMCID: PMC4615852 DOI: 10.1155/2015/137381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/17/2015] [Indexed: 11/17/2022] Open
Abstract
Papillion-Lefèvre Syndrome is a very rare disorder of autosomal recessive inheritance distinguished by palmar plantar hyperkeratosis and early onset of periodontitis affecting the dentition. Genetic studies have identified a mutation in the major gene locus of chromosome 11q14 with loss of function. Cathepsin C gene is to be responsible for Papillion-Lefèvre Syndrome. The present case report describes a 13-year-old female, who visited the Department of Periodontology with the chief compliant of bleeding gums and loose teeth. She presented with the signs and symptoms of Papillion-Lefèvre Syndrome. The patient had premature shedding of her deciduous dentition. On clinical examination, extraorally, the patient presented with persistent thickening, flaking, and scaling of the skin of palms and soles. Her intraoral examination revealed gingival inflammation, abscess formation, and periodontal pockets. Her intraoral radiographs showed bone loss involving the central incisors and molars. The patient underwent periodontal therapy and is under maintenance.
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17
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Sørensen OE, Clemmensen SN, Dahl SL, Østergaard O, Heegaard NH, Glenthøj A, Nielsen FC, Borregaard N. Papillon-Lefèvre syndrome patient reveals species-dependent requirements for neutrophil defenses. J Clin Invest 2014; 124:4539-48. [PMID: 25244098 DOI: 10.1172/jci76009] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 07/10/2014] [Indexed: 01/26/2023] Open
Abstract
Papillon-Lefèvre syndrome (PLS) results from mutations that inactivate cysteine protease cathepsin C (CTSC), which processes a variety of serine proteases considered essential for antimicrobial defense. Despite serine protease-deficient immune cell populations, PLS patients do not exhibit marked immunodeficiency. Here, we characterized a 24-year-old woman who had suffered from severe juvenile periodontal disease, but was otherwise healthy, and identified a homozygous missense mutation in CTSC indicative of PLS. Proteome analysis of patient neutrophil granules revealed that several proteins that normally localize to azurophil granules, including the major serine proteases, elastase, cathepsin G, and proteinase 3, were absent. Accordingly, neutrophils from this patient were incapable of producing neutrophil extracellular traps (NETs) in response to ROS and were unable to process endogenous cathelicidin hCAP-18 into the antibacterial peptide LL-37 in response to ionomycin. In immature myeloid cells from patient bone marrow, biosynthesis of CTSC and neutrophil serine proteases appeared normal along with initial processing and sorting to cellular storage. In contrast, these proteins were completely absent in mature neutrophils, indicating that CTSC mutation promotes protease degradation in more mature hematopoietic subsets, but does not affect protease production in progenitor cells. Together, these data indicate CTSC protects serine proteases from degradation in mature immune cells and suggest that neutrophil serine proteases are dispensable for human immunoprotection.
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18
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Fantasia JE. Syndromes with unusual dental findings or gingival components. Atlas Oral Maxillofac Surg Clin North Am 2014; 22:211-219. [PMID: 25172002 DOI: 10.1016/j.cxom.2014.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- John E Fantasia
- Hofstra North Shore-Long Island Jewish School of Medicine, 270-05 76th Avenue, New Hyde Park, NY 11040, USA.
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19
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Yasudo H, Ando T, Takeuchi M, Nakano H, Itonaga T, Takehara H, Isojima T, Miura K, Harita Y, Takita J, Oka A. Systemic lupus erythematosus complicated with liver cirrhosis in a patient with Papillon-Lefèvre syndrome. Lupus 2014; 23:1523-7. [DOI: 10.1177/0961203314547794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We report the first case of a girl who presented with Papillon-Lefèvre syndrome (PLS) and subsequently developed systemic lupus erythematosus and liver cirrhosis. This indicates that autoimmune diseases can be a complication in patients with PLS. Cathepsin C gene mutations were not found in our patient or her mother. Thus, other genetic factors may have been involved in this patient.
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Affiliation(s)
- H Yasudo
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - T Ando
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
- Laboratory for Allergic Disease, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | - H Nakano
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - T Itonaga
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - H Takehara
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - T Isojima
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - K Miura
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Y Harita
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - J Takita
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - A Oka
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
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20
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Kaliyadan F, Nambiar A. Palmoplantar keratoderma with dental abnormalities. Indian Dermatol Online J 2014; 5:232-4. [PMID: 24860777 PMCID: PMC4030370 DOI: 10.4103/2229-5178.131152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Feroze Kaliyadan
- Department of Dermatology, King Faisal University, Hofuf, Saudi Arabia and Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Ajit Nambiar
- Department of Pathology, King Faisal University, Hofuf, Saudi Arabia
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21
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Vieira AR, Albandar JM. Role of genetic factors in the pathogenesis of aggressive periodontitis. Periodontol 2000 2014; 65:92-106. [DOI: 10.1111/prd.12021] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2012] [Indexed: 12/14/2022]
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22
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Moghaddasian M, Arab H, Dadkhah E, Boostani H, Babak AR, Abbaszadegan MR. Protein modeling of cathepsin C mutations found in Papillon–Lefèvre syndrome. Gene 2014; 538:182-7. [DOI: 10.1016/j.gene.2013.11.079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 11/26/2013] [Accepted: 11/30/2013] [Indexed: 11/15/2022]
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23
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Chen L, Zhang M, Li H, Tang S, Fu X. Distribution of BrdU label-retaining cells in eccrine sweat glands and comparison of the percentage of BrdU-positive cells in eccrine sweat glands and in epidermis in rats. Arch Dermatol Res 2014; 305:453-5. [PMID: 23907330 DOI: 10.1007/s00403-013-1323-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 01/29/2013] [Accepted: 01/31/2013] [Indexed: 02/05/2023]
Abstract
Bromodeoxyuridine (BrdU) has commonly been used for detecting of label-retaining cells (LRCs). To determine if there are LRCs and the distributions of LRCs in eccrine sweat glands, 20 newborn SD rats within 24 h after birth were injected intraperitoneally with 50 mg/kg/time BrdU four consecutive times at 2-h intervals, or twice daily at 2-h intervals for four consecutive days. Six weeks after the last BrdU injection, rats were sacrificed, and the hind footpads were harvested, fixed and embedded in paraffin. Five-micrometer thickness tissue sections were cut and the expression of BrdU was detected immunohistochemically. The results showed that BrdU(+) cells were scatteredly distributed in coiled secretory part and coiled duct, as well as the straight duct, but not the intraepidermal duct of eccrine sweat glands. In secretory part, besides secretory cells, myoepithelial cells showed label retaining. The percentage of BrdU(+) cells in eccrine sweat gland of rat footpads had no significant difference between the two injection methods of BrdU (50 mg/kg/time BrdU four consecutive times at 2-h intervals vs. 50 mg/kg/time BrdU twice daily at 2-h intervals for four consecutive days) (P > 0.05). The percentage of BrdU(+) cells in eccrine sweat glands (4.2 ± 1.3 %) was significantly higher than that in stratum basale of epidermis (0.5 ± 0.1 ‰) (P < 0.05). In conclusion, there were LRCs in eccrine sweat glands of rat footpads, and these LRCs might play important roles in the homeostasis of skin and its appendages.
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Affiliation(s)
- Lu Chen
- Burn and Plastic Surgery, The Second Affiliated Hospital, Shantou University Medical College, North DongXia Road, Shantou, 515041, Guangdong, People's Republic of China
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Kanthimathinathan HK, Browne F, Ramirez R, McKaig S, Debelle G, Martin J, Chapple ILC, Kay A, Moss C. Multiple cerebral abscesses in Papillon-Lefèvre syndrome. Childs Nerv Syst 2013; 29:1227-9. [PMID: 23686359 DOI: 10.1007/s00381-013-2152-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/07/2013] [Indexed: 11/25/2022]
Abstract
Papillon-Lefèvre syndrome is characterised by palmoplantar keratoderma, periodontitis and pyogenic infections. We describe the first case of brain abscess in a child with this syndrome. We highlight the importance of recognising any associated diagnosis, however rare or apparently irrelevant, in an acutely and critically ill child.
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25
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Dalgic B, Bukulmez A, Sari S. Pyogenic liver abscess and peritonitis due to Rhizopus oryzae in a child with Papillon-Lefevre syndrome. Eur J Pediatr 2011; 170:803-5. [PMID: 21165748 DOI: 10.1007/s00431-010-1368-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Accepted: 11/24/2010] [Indexed: 11/26/2022]
Abstract
Papillon-Lefevre syndrome (PLS) is an autosomal recessive disease that is characterized by symmetric palmoplantar keratodermatitis and severe periodontal destruction. Mutations in the cathepsin C gene (CTSC) have recently been detected in PLS. Immune dysregulation, due to a mutation in CTSC, increases the risk of pyogenic infections in PLS patients. A child with PLS is presented here with liver abscesses and peritonitis caused by Rhizopus oryzae. His liver abscess and peritonitis were cured with amphotericin B without surgical care. This is the first case in the literature liver abscess due to Rhizopus oryzae in a child with PLS.
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Affiliation(s)
- Buket Dalgic
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gazi University, Besevler, 06500, Ankara, Turkey
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