RESUMEN
OBJECTIVE: Predictive factors associated with clinical outcomes of chronic norovirus infection (CNI) in primary immunodeficiency diseases (PIDD) are lacking. METHOD: We sought to characterize CNI using a multi-institutional cohort of patients with PIDD and CNI using the Clinical Immunology Society's CIS-PIDD Listserv e-mail group. RESULTS: Thirty-four subjects (21 males and 13 females) were reported from centers across North America, Europe, and Asia. All subjects were receiving high doses (median IgG dose: 1200â¯mg/kg/month) of supplemental immunoglobulin therapy. Fifty-three percent had a complete absence of B cells (median B-cell count 0; range 0-139 cells/µL). Common Variable Immune Deficiency (CVID) subjects manifested a unique phenotype with B-cell lymphopenia, non O+ blood type, and villous atrophy (logistic regression model, Pâ¯=â¯0.01). Five subjects died, all of whom had no evidence of villous atrophy. CONCLUSION: While Norovirus (NoV) is thought to replicate in B cells, in this PIDD cohort of CNI, B-cell lymphopenia was common, indicating that the presence of B lymphocytes is not essential for CNI.
Asunto(s)
Infecciones por Caliciviridae/inmunología , Síndromes de Inmunodeficiencia/virología , Norovirus/fisiología , Adolescente , Adulto , Linfocitos B/patología , Infecciones por Caliciviridae/mortalidad , Infecciones por Caliciviridae/patología , Enfermedad Crónica , Inmunodeficiencia Variable Común/inmunología , Inmunodeficiencia Variable Común/patología , Inmunodeficiencia Variable Común/terapia , Inmunodeficiencia Variable Común/virología , Femenino , Gastroenteritis/inmunología , Gastroenteritis/mortalidad , Gastroenteritis/patología , Humanos , Inmunización Pasiva , Síndromes de Inmunodeficiencia/inmunología , Síndromes de Inmunodeficiencia/patología , Síndromes de Inmunodeficiencia/terapia , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Norovirus/genética , Estudios Retrospectivos , Adulto JovenRESUMEN
Anti-epileptic drugs are considered to be the main drugs associated with gingival overgrowth. The co-administration of phenytoin and other anti-epileptic drugs, which increases the risk of phenytoin-induced gingival overgrowth, has been previously reported. However, no report has been done considering the new generation of anti-epileptic drug topiramate and its association with gingival overgrowth. High levels of dental plaque and calculus have also been reported as being a critical risk factor in the development and severity of drug-induced gingival overgrowth. Thus, this case report highlights the occurrence of severe gingival overgrowth and generalized periodontitis in a physically disabled patient with epilepsy who had been taking phenytoin and topiramate drugs for 10 years. It also emphasizes the importance for both medical and dental professionals to reduce the severity and impact of drug-induced gingival overgrowth.
RESUMEN
A one-day intensive educational course on allergy and immunology theory and diagnostic procedure significantly increased the competency of allergy and immunology fellows-in-training.