Involvement of the jaw bones in systemic mastocytosis

Oral manifestations of hematologic and nutritional diseases

Oral manifestations of hematologic and nutritional deficiencies can affect the mucous membranes, teeth, periodontal tissues, salivary glands, and perioral skin. This article reviews common oral manifestations of hematologic conditions starting with disorders of the white blood cells including cyclic hematopoiesis (cyclic neutropenia), leukemias, lymphomas, plasma cell dyscrasias, and mast cell disorders; this is followed by a discussion of the impact of red blood cell disorders including anemias and less common red blood cell dyscrasias (sickle cell disease, hemochromatosis, and congenital erythropoietic porphyria) as well as thrombocytopenia. Several nutritional deficiencies exhibit oral manifestations. The authors specifically discuss the impact of water-soluble vitamins (B2, B3, B6, B9, B12, and C), fat-soluble vitamins (A, D, and K) and the eating disorders anorexia nervosa and bulimia nervosa on the oral mucosa.

Case report: pathologic long bone fracture in a patient with systemic mastocytosis

Systemic mastocytosis is characterized by clonal proliferation of mast cells, which cause disease by accumulating in various organs and releasing their chemical products into tissues. We highlight a patient with systemic mastocytosis that caused a pathologic femur fracture in a 63-year-old man with minimal trauma. The typical presentation of bone involvement is a combination of mixed sclerotic and osteolytic lesions, but this patient also had osteopenia. Although bone involvement is common in patients with systemic mastocytosis, pathologic fractures outside the vertebral column are rare. The patient was treated with intramedullary fixation of his femur and retained adequate fixation at the time of his death 7 months postoperatively. We review the literature on pathologic fractures outside the vertebral column in patients with systemic mastocytosis.