RESUMEN
Treatment for acute lymphoblastic leukemia (ALL) mainly consists of chemotherapy, irradiation and bone marrow transplantation. In terms of long-term treatment effects, dental abnormalities and chronic graft-versus host disease (GVHD) are problems. We present a patient surviving relapse of ALL at one year of age. He had extreme dental abnormalities and multiple caries. Most of his permanent teeth were abnormal, and multiple caries were observed. Since he had a strong vomiting reaction to dental treatment, general anesthesia was given. During the general anesthesia, much sputum was aspirated because of chronic GVHD. His dental condition was worse than other cases reported previously. Since the survival rate has increased recently, the dental effects of ALL treatment have become significant. Especially, in patients undergoing total body irradiation at under 2 years of age, it is highly likely that dental problems will occur in the future.
Asunto(s)
Anestesia Dental/métodos , Trasplante de Médula Ósea/efectos adversos , Enfermedad Injerto contra Huésped/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Anomalías Dentarias/etiología , Irradiación Corporal Total/efectos adversos , Anomalías Múltiples/etiología , Obstrucción de las Vías Aéreas/etiología , Anestesia Dental/efectos adversos , Anestesia General/efectos adversos , Enfermedad Crónica , Caries Dental/etiología , Caries Dental/terapia , Restauración Dental Permanente , Enfermedad Injerto contra Huésped/etiología , Humanos , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamiento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/radioterapia , RecurrenciaRESUMEN
Some dental patients have histories of adverse reactions to local anesthesia. The aim of the present study was to investigate the frequency of allergy to local anesthetics of dental patients who had histories of adverse reactions to local anesthesia based on the results of allergy tests in our institute over a period of 5 years. We investigated the past medical records of dental patients retrospectively, and twenty patients were studied. Three of the 20 showed a positive or false-positive reaction in the intracutaneous test, and one patient showed a false-positive reaction in the challenge test. Our results suggest that the frequency of allergy to local anesthetics is low even if patients have histories of adverse reactions to local anesthesia. However, allergy tests of local anesthetics should be performed in patients in whom it is uncertain whether they are allergic.