年龄相关免疫衰老：模仿颌骨药物性骨坏死的腭部爱泼斯坦-巴尔病毒阳性黏膜皮肤溃疡
Age Related Immunosenescence Epstein-Barr Virus-positive Mucocutaneous Ulcer of the Palate Mimicking Medication-related Osteonecrosis of the Jaw.
作者信息
Fukuzawa Satoshi, Yamagata Kenji, Terada Kazuhiro, Uchida Fumihiko, Ishibashi-Kanno Naomi, Bukawa Hiroki
机构信息
Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 Japan.
出版信息
Indian J Otolaryngol Head Neck Surg. 2022 Dec;74(Suppl 3):4593-4597. doi: 10.1007/s12070-021-02859-4. Epub 2021 Sep 16.
Epstein-Barr virus (EBV) -positive mucocutaneous ulcer (EBVMCU) was first described as a lymphoproliferative disorder in 2010. In recent years, EBVMCU has been reported in the field of oral surgery. On the other hand, medication-related osteonecrosis of the jaw (MRONJ) is an osteomyelitis that occurs in patients receiving antiresorptive agents including bisphosphonates (BP) and/or denosumab developing with bacterial infections such as dental diseases and mucositis. MRONJ caused by EBVMCU in the elderly has not been reported. Here, we report a rare case of MRONJ caused by EBVMCU in the elderly. The patient, an 82-year-old woman, had received BP for more than 2 years. An ulcerative lesion was found in the palatal mucosa; biopsy performed from the site confirmed the diagnosis of EBVMCU. At follow-up, the lesion disappeared spontaneously. At the 6-month follow-up, bone formation was observed at the site of the lesion, and the sequestrum was removed. At the 12-month follow-up healing of the EBVMCU region was seen indicating a good prognosis.
爱泼斯坦-巴尔病毒（EBV）阳性黏膜皮肤溃疡（EBVMCU）于2010年首次被描述为一种淋巴增殖性疾病。近年来，口腔外科领域已有EBVMCU的报道。另一方面，药物相关性颌骨坏死（MRONJ）是一种骨髓炎，发生在接受包括双膦酸盐（BP）和/或地诺单抗在内的抗吸收剂治疗的患者中，由诸如牙科疾病和黏膜炎等细菌感染引发。老年患者中由EBVMCU引起的MRONJ尚未见报道。在此，我们报告一例老年患者中由EBVMCU引起的罕见MRONJ病例。该患者为一名82岁女性，接受BP治疗超过2年。在腭黏膜发现一个溃疡性病变；从该部位进行的活检确诊为EBVMCU。随访时，病变自行消失。在6个月随访时，在病变部位观察到骨形成，并取出了死骨。在12个月随访时，EBVMCU区域愈合，提示预后良好。
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