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自闭症谱系障碍患者的严重浆细胞性粘膜炎表现:一种独特的重叠现象,说明了诊断和管理的挑战。

Severe manifestation of plasma cell mucositis in a patient with autism spectrum disorder: A unique overlap illustrating challenges with diagnosis and management.

机构信息

Department of Oral Medicine, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Access Dental Associates, BrookHaven, Pennsylvania, USA.

出版信息

Spec Care Dentist. 2024 Nov-Dec;44(6):1608-1614. doi: 10.1111/scd.13053. Epub 2024 Aug 16.

Abstract

Plasma cell mucositis (PCM) is a rare inflammatory condition affecting the oral tissues, often triggered by allergens or inflammation. Autism spectrum disorder (ASD), a neurodevelopmental condition, poses unique challenges in oral care and hygiene due to behavioral and sensory issues. These conditions have not previously been reported in concert but may share risk factors including through the development of inflammation. We present a case of severe PCM in a 23-year-old male with ASD, illustrating diagnostic complexities and management strategies. The patient presented with widespread and severe lesions, raising the possibility of underlying causes. After multiple interventions, including topical steroids and trigger avoidance, the patient achieved near-complete resolution of the oral lesions. Immunohistochemical and serological investigations suggested an underlying monoclonal gammopathy, warranting hematological evaluation. Our case shows how PCM and ASD can affect each other, highlighting the importance of understanding how these conditions interact, and the need for tailored approaches to oral health in this population. Further research is needed to elucidate any pathophysiological or risk-based link between ASD and inflammatory oral conditions and to refine management strategies for PCM in patients with neurodevelopmental disorders.

摘要

浆细胞性黏膜炎(PCM)是一种罕见的影响口腔组织的炎症性疾病,通常由过敏原或炎症引发。自闭症谱系障碍(ASD)是一种神经发育障碍,由于行为和感官问题,在口腔护理和卫生方面带来了独特的挑战。这些病症以前没有同时报告过,但可能通过炎症的发展而具有共同的风险因素。我们报告了一例 23 岁男性 ASD 患者发生严重 PCM 的病例,说明了诊断的复杂性和管理策略。该患者表现为广泛而严重的病变,提示可能存在潜在病因。经过多次干预,包括局部类固醇和避免触发因素,患者的口腔病变几乎完全消退。免疫组化和血清学研究提示存在潜在的单克隆丙种球蛋白病,需要进行血液学评估。我们的病例表明 PCM 和 ASD 如何相互影响,强调了理解这些病症相互作用的重要性,以及在该人群中针对口腔健康制定个性化方法的必要性。需要进一步研究来阐明 ASD 和炎症性口腔疾病之间是否存在任何病理生理学或基于风险的联系,并完善神经发育障碍患者 PCM 的管理策略。

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