2014, Number 4
<< Back Next >>
Rev Med Inst Mex Seguro Soc 2014; 52 (4)
Oral lesions associated to immunosuppression in kidney transplant patients
de la Rosa-García E, Mondragón-Padilla A
Language: Spanish
References: 28
Page: 442-447
PDF size: 194.45 Kb.
ABSTRACT
Background: The use of immunosuppresive drugs in patients with kidney
transplantation (KT) could infl uence the development of oral lesions
(OL). The aim of this study was to establish the OL prevalence in a group
of KT patients, and explore some possible associations of their presence.
Methods: Cross-sectional study. We examined the oral mucosa (OM) of
190 KT patients searching for OL. Our fi ndings were analyzed by multiple
logistic regression, and possible associations between OLs and several
variables (demographic, clinical, of immunosuppressor drugs, and of lab
results) were explored.
Results: Overall OL prevalence was 28.4 %; 15.8 % had oral candidiasis
(which was more prevalent in diabetic cases,
p = 0.002), herpes simplex
7.4 %, hairy leukoplakia 5.3 %, oral verruca vulgaris 3.7 %, and OM
ulcers 2.6 %. The combination of cyclosporin A + azathioprine + prednisone
had the highest OL prevalence. Hairy leukoplakia was related to
a lower total leukocyte count,
p = 0.006, and oral verruca vulgaris to a
cadaveric KT donor.
Conclusions: Oral candidiasis was the most prevalent OL, and it was
more prevalent in diabetic cases. The association of hairy leukoplakia to
a lower total leukocyte count might agree with previous reports classifying
it as an immunosuppression marker.
REFERENCES
Carpenter CB, Milford E, Sayegh MH. Transplantation in the treatment of renal failure. En: Kasper DL, Braunwald E, Fauci AS, eds. Harrison´s Principles of Internal Medicine. New York. 16th ed. McGraw-Hill; 2010:1668-74.
Parisi E, Glick M. Immune suppression and considerations for dental care. Dent Clin North Am. 2003; 47:709-31.
Wilkinson A, Kasisike BL. Long-term post-transplantation management and complications. En: Danovich GM (ed). Handbook of Kidney Transplantation. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2010. p. 219-22.
Srinivas TR, Meier-Kriesche HU. Minimizing Immunosuppression, an Alternative Approach to Reducing Side Effects: Objectives and Interim Result. Clin J Am Soc Nephrol. 2008;3:S101-S116.
López-Pintor RM, Hernández G, de Arriba L, de Andrés A. Comparison of oral lesion prevalence in renal transplant patients under immunosuppressive therapy and healthy controls. Oral Dis. 2010;16:89-95.
De la Rosa-García E, Mondragón-Padilla A, Irigoyen- Camacho ME, Bustamante-Ramírez MA. Lesiones bucales en un grupo de pacientes con transplante renal. Med Oral Patol Oral Cir Bucal. 2005;10:196-204.
Van Gelder T, TerMeulen CG, Hené R, Weimar W, Hoitsma A. Oral ulcers in kidney transplant recipients treated with sirolimus and mycophenolate mofetil. Transplantation. 2003;75:788-91.
[No authors listed] Classifi cation and diagnostic criteria for oral lesions in HIV infection. EC-Clearinghouse on Oral Problems Related to HIV Infection and WHO Collaborating Centre on Oral Manifestations of the Immunodefi ciency virus (1993). J Oral Pathol Med. 1993;22:289-91.
Spolidorio LC, Spolidorio DMP, Massucato EMS, Neppelenbrock KN, Campanha NH, Sanches MH. Oral health in renal transplant recipients administered cyclosporin A or tacrolimus. Oral Dis. 2006; 12:309-14.
Al-Mohaya MA, Darwazeh AM, Bin-Salih S, Al- Khudair W. Oral lesions in Saudi renal transplant patients. Saudi J Kidney Dis Transpl. 2009; 20:20-9.
López-Pintor RM, Hernández G, de Arriba L, de Andrés A. Oral candidiasis in patients with renal transplants. Med Oral Patol Oral Cir Bucal. 2013; 18:e381-7.
Da Silva LC, de Almeida Freitas R, de Andrade MP Jr, Piva MR, Martins-Filho PR, de Santana Santos T. Oral lesions in renal transplant. J Craniofac Surg. 2012;23: e214-8.
King GN, Healy CM, Glover MT, Kwan JT, Williams DM, Leigh IM, et al. Prevalence and risk factors associated with leukoplakia, hairy leukoplakia, erythematous candidiasis, and gingival hyperplasia in renal transplant recipients. Oral Surg Oral Med Oral Pathol. 1994;78:718-26.
De la Rosa GE, Mondragón PA, Aranda S, Cruz MS. Frecuencia de manifestaciones bucales en pacientes diabéticos tipo 2 de una unidad de Medicina FaRev Med Inst Mex Seguro Soc. 2014;52(4):442-7 447 De la Rosa-García E et al. Lesiones bucales asociadas a inmunosupresión miliar del IMSS. Revista de Ciencias Clínicas. 2006; 7:81-8.
Kurnatowska I, Pazurek M, Nowicki M. Case of esophagitis in a posttansplant female patient. Ann Transplant. 2007;12:39-42.
Dirschnabel AJ, Martins A de S, Dantas SA, Ribas M de O, Grégio AM, Alanis LR, et al. Clinical oral fi ndings in dialysis and kidney-transplant patients. Quintessence Int. 2011;42:127-33.
Chen YK, Hou HA, Chow JM, Chen YC, Hsueh PR, Tien HF. The impact of oral herpes simplex virus infection and candidiasis on chemotherapyinduced oral mucositis among patients with hematological malignancies. Eur J Clin Microbiol Infect Dis. 2011;30:753-9.
De la Rosa García E, Bologna Molina R, Vega González T de J. Graft-versus-host disease, an eight case report and literature review. Med Oral Patol Oral Cir Bucal. 2006;11:E486-92.
Lima RB, Santos PSS, Malafronte P, Muller H, Caiaffa-Filho H, Sens YAS. Oral manifestation of cytomegalovirus associated with herpes simplex virus in renal transplant recipient. Transplant Proc. 2008;40:1378-81.
Olczak-Kowalczyk D, Pawłowska J, Cukrowska B, Kluge P, Witkowska-Vogtt E, Dzierzanowska-Fangrat K, et al. Local presence of cytomegalovirus and Candida species vs oral lesions in liver and kidney transplant recipients. Ann Transplant. 2008;13:28-33.
Piperi E, Omlie J, Koutlas IG, Pambuccian S. Oral hairy leukoplakia in HIV-negative patients: report of 10 cases. Int J Surg Pathol. 2010;18:177-83.
Chuang P, Langone AJ. Clobetasol ameliorates aphthous ulceration in renal transplant patients on sirolimus. Am J Transplantation. 2007;7:714-7.
Naranjo J, Poniachik J, Cisco D, Contreras J, Oksentberg D, Valera JM, et al. Oral ulcers produced by mycophenolate mofetil in two liver transplant patients. Transplan Proc. 2007;39:612-4.
Natah SS, Häyrinen-Immonen R, Hietanen J, Patinen P, Malmström M, Savilahti E, et al. Increased density of lymphocytes bearing gamma/delta T-cell receptors in recurrent aphthous ulceration (RAU). Int J Oral Maxillofac Surg. 2000;29:375-80.
Zachariae C, Sand C, Hansen JM, Sørensen SS, Koch K, Villumsen J, et al. Warts in a cohort of Danish kidney transplanted patients: impact on quality of life. Acta Derm Venereol. 2012;92:615-8.
Genzer O, El-Sayegh SE, Kleiner MJ, Castellanos MR. Male human papillomavirus infection post-kidney transplant: an overlooked disease. Transplant Res. 2012;1:21.
Anaya-Saavedra G, Ramírez-Amador V, Irigoyen- Camacho ME, García-Cuellar CM, Guido- Jiménez M, Méndez-Martínez R, et al. High association of human papillomavirus infection with oral cancer: a case-control study. Arch Med Res. 2008;39:189-97.
Al-Osman A, Perry JB, Birek C. Extensive papillomatosis of the palate exhibiting epithelial dysplasia and HPV 16 gene expression in a renal transplant recipients. J Can Dent Assoc. 2006;72:331-4.