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Ⅰ型糖原贮积病的牙周表现:一例罕见病例报告。

Periodontal Manifestation of Type Ib Glycogen Storage Disease: A Rare Case Report.

机构信息

Department of Periodontics, King Hussein Medical Center, Royal Medical Services, Amman, Jordan.

King Hussein Medical Center, Amman, Jordan.

出版信息

Clin Adv Periodontics. 2020 Sep;10(3):150-154. doi: 10.1002/cap.10112. Epub 2020 Jul 28.

Abstract

INTRODUCTION

Glycogen storage diseases (GSD) are genetic metabolic disorders of glycogen metabolism. There are >15 types based on the enzyme deficiency and the affected organ. Glycogen storage disease Type Ib is the only type associated with neutropenia and periodontitis. This type is caused by a deficiency of glucose-6-phosphate (G6P) translocase which prevents the transport of G6P across the endoplasmic reticulum. As a result, glycogen cannot be metabolized into glucose with its subsequent accumulation in tissues. The affected organs involved in Type Ib are the liver, kidney, and intestine.

CASE PRESENTATION

A 5-year-old Jordanian boy from a consanguineous family referred to the periodontal clinic in February 2014 with an established diagnosis of GSD-Ib. The systemic manifestations include hepatomegaly, hypoglycemia, hyperprolactenemia, inflammatory bowel disease, osteoporosis, and neutropenia. Oral manifestations include severe gingival inflammation and recurrent oral ulceration disease.

CONCLUSIONS

The clinical signs and symptoms of periodontal disease in GSD Type Ib are similar to those found in patients diagnosed with neutropenia. Future studies are needed to clarify whether severe generalized inflammation of the gingiva in children is part of the GSD Type Ib or is a separate entity caused by neutrophil dysfunction.

摘要

简介

糖原贮积病(GSD)是一种遗传性代谢疾病,影响糖原代谢。根据酶缺乏和受累器官的不同,可分为 15 种以上类型。糖原贮积病 Ib 型是唯一与中性粒细胞减少症和牙周炎相关的类型。这种类型是由于葡萄糖-6-磷酸(G6P)转位酶缺乏引起的,该酶阻止 G6P 穿过内质网运输。结果,糖原不能代谢成葡萄糖,随后在组织中积累。受影响的器官包括肝、肾和肠。

病例介绍

2014 年 2 月,一名来自约旦的 5 岁男孩因糖原贮积病 Ib 型被转诊至牙周病诊所,该男孩来自近亲家庭。全身表现包括肝肿大、低血糖、高催乳素血症、炎症性肠病、骨质疏松症和中性粒细胞减少症。口腔表现包括严重的牙龈炎症和复发性口腔溃疡疾病。

结论

糖原贮积病 Ib 型牙周病的临床症状与诊断为中性粒细胞减少症的患者相似。需要进一步的研究来阐明儿童牙龈广泛性严重炎症是否是糖原贮积病 Ib 型的一部分,还是由中性粒细胞功能障碍引起的独立实体。

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