Domínguez Reyes Antonia, Aznar Martín Teresa, Barbería Leache Elena, Cabrera Suárez Eugenio
Odontología Infantil Integrada, Facultad de Odontología, Universidad de Sevilla, España.
Med Oral. 2003 Nov-Dec;8(5):361-5.
This study has been carried out in order to understand and increase our knowledge about the oral manifestations and the treatment required for Graft Versus Host Disease. The complication of allogeneic transplants with haematopoietic cells is revised. The clinical case report deals with a nine-year-old girl who was treated in our unit of Integrated Paediatric Dentistry after referral by her paediatrician. The symptoms of Graft Versus Host Disease are basically characterised by immunodeficiency, diarrhoea, weight loss, dermatological and hepatic alterations and oral manifestations. This group of syndromes, caused by the fact that the receptor acquires 30% to 50% of the donor's immune system, can become acute leading to a 20% to 30% mortality rate. The syndromes are chronic in 50% of cases, when sometimes the destruction of the salivary glands is the only manifestation and has a mortality rate of 5%. From the odontological point of view 80% of patients are affected, although we should make the distinction between the manifestations which are directly caused by the disease, and those caused by chemotherapy or radiotherapy. Oral manifestations (caries, mucositis, ulcers, infections, etc) should be treated as soon as possible. Positive co-operation between physicians is of vital importance.
开展这项研究是为了了解并增加我们对移植物抗宿主病的口腔表现及所需治疗的认识。对异基因造血细胞移植的并发症进行了综述。临床病例报告涉及一名9岁女孩，她在儿科医生转诊后，在我们的综合儿童牙科科室接受治疗。移植物抗宿主病的症状主要表现为免疫缺陷、腹泻、体重减轻、皮肤和肝脏改变以及口腔表现。这组综合征是由于受体获得了供体30%至50%的免疫系统而引起的，可能会发展为急性，导致20%至30%的死亡率。在50%的病例中，这些综合征为慢性，有时唾液腺破坏是唯一表现，死亡率为5%。从牙科学角度来看，80%的患者会受到影响，不过我们应该区分由疾病直接引起的表现和由化疗或放疗引起的表现。口腔表现（龋齿、粘膜炎、溃疡、感染等）应尽快治疗。医生之间的积极合作至关重要。
