Mezaiko Eleazar, Teixeira Brito Lucas, Britto Cançado Barbara Luiza de, da Silva Junior Weldes Francisco, Yamamoto-Silva Fernanda Paula, de Freitas Silva Brunno Santos
Universidade Federal de Goiás, Goiânia, Brazil.
Governor Otávio Lage de Siqueira State Emergency Hospital, Goiânia, Brazil.
Oral Maxillofac Surg. 2024 Dec 12;29(1):20. doi: 10.1007/s10006-024-01310-6.
This report aims to present an interdisciplinary approach to diagnosing and treating a case of Common Variable Immunodeficiency (CVID), an inborn error of immunity, resulting in successive complications following a third molar extraction procedure.
The patient, a 37-year-old Caucasian female, sought a specialist for the extraction of an impacted lower third molar associated with dentigerous cyst. Due to the possibility of mandibular fracture, a bone fixation system was used in the region. However, she experienced recurrent infections following the procedure despite various treatments and hospitalizations, and these infections could not be explained by any factors. The diagnosis of CVID was established through exclusionary factors, low immunoglobulin levels, and comprehensive allergy assessments by an immunologist. Resolution of the patient's condition and discharge were achieved only after removing the fixation system and implementing monthly immunoglobulin infusions.
CVID is often diagnosed late, resulting in significant economic, social, and health burdens, including recurrent hospitalizations, allergies, and increased risk of malignancy. This case underscores the importance of considering CVID in patients presenting with unexplained recurrent infections following oral and maxillofacial surgeries. Additionally, it highlights the necessity of a multidisciplinary approach for effectively managing patients with CVID.
本报告旨在介绍一种跨学科方法,用于诊断和治疗一例常见可变免疫缺陷病(CVID),这是一种遗传性免疫缺陷疾病,在拔除第三磨牙手术后引发了一系列并发症。
患者为一名37岁的白种女性,因含牙囊肿寻求专科医生拔除右下阻生第三磨牙。由于存在下颌骨折的可能性,该区域使用了骨固定系统。然而,尽管进行了各种治疗和住院治疗,术后她仍反复感染,且这些感染无法用任何因素解释。通过排除性因素、低免疫球蛋白水平以及免疫学家进行的全面过敏评估,确诊为CVID。仅在移除固定系统并每月进行免疫球蛋白输注后,患者的病情才得到缓解并出院。
CVID往往诊断较晚,会导致重大的经济、社会和健康负担,包括反复住院、过敏以及恶性肿瘤风险增加。本病例强调了在口腔颌面外科手术后出现不明原因反复感染的患者中考虑CVID的重要性。此外,它突出了采用多学科方法有效管理CVID患者的必要性。