Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Cidade Universitária, Rio de Janeiro, RJ, Brazil.
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Head Neck Pathol. 2024 Jun 19;18(1):54. doi: 10.1007/s12105-024-01652-3.
Uremic stomatitis is often unfamiliar to healthcare professionals. This study presents five cases of uremic stomatitis, providing a comprehensive analysis of their demographic distribution, clinicopathological features, and management strategies based on existing literature.
Data were collected from centers across Brazil, Argentina, Venezuela, and Mexico. Electronic searches were conducted in five databases supplemented by manual scrutiny and gray literature.
The series consisted of three men and two women with a mean age of 40.2 years. Lesions mostly appeared as white plaques, particularly on the tongue (100%). The median blood urea level was 129 mg/dL. Histopathological analysis revealed epithelial changes, including acanthosis and parakeratosis, with ballooned keratinocytes in the suprabasal region. Oral lesions resolved subsequent to hemodialysis in three cases (75%). Thirty-seven studies comprising 52 cases of uremic stomatitis have been described hitherto. Most patients were male (65.4%) with a mean age of 43.6 years. Clinically, grayish-white plaques (37.3%) and ulcers/ulcerations (28.9%) were common, particularly on the tongue (30.9%). Hemodialysis was performed on 27 individuals. The resolution rate of oral lesions was 53.3%.
Earlier recognition of uremic stomatitis, possibly associated with long-term uremia, holds the potential to improve outcomes for patients with undiagnosed chronic kidney disease.
尿毒症性口腔炎常不为医护人员所熟悉。本研究报告了 5 例尿毒症性口腔炎病例，根据现有文献对其人口统计学分布、临床病理特征和管理策略进行了全面分析。
数据来自巴西、阿根廷、委内瑞拉和墨西哥的多个中心。在五个数据库中进行了电子检索，并辅以手工查阅和灰色文献。
该系列包括 3 名男性和 2 名女性，平均年龄为 40.2 岁。病变主要表现为白色斑块，尤其是舌部（100%）。中位血尿素水平为 129mg/dL。组织病理学分析显示上皮变化，包括棘层肥厚和角化不全，棘层上部有气球样角化细胞。3 例（75%）患者在接受血液透析后口腔病变消退。迄今已描述了 37 项研究，共 52 例尿毒症性口腔炎病例。大多数患者为男性（65.4%），平均年龄为 43.6 岁。临床上，灰白色斑块（37.3%）和溃疡/糜烂（28.9%）较为常见，尤其是舌部（30.9%）。27 例患者接受了血液透析。口腔病变的缓解率为 53.3%。
更早地识别尿毒症性口腔炎，可能与长期尿毒症有关，有望改善未确诊的慢性肾脏病患者的预后。
