Parotiditis recurrente y déficit de células natural killer: ¿coincidencia o patogenia? / Juvenile recurrent parotitis and natural killer cells deficiency, coincidence or pathogenesis?

La parotiditis recurrente juvenil puede tener multitud de causas, es importante tener en cuenta, dentro de la etiología, el estudio de las subpoblaciones linfocitarias, ya que puede haber una relación patogénica con la deficiencia de células natural killer. Se presenta el caso clínico de una paciente de diez años con parotiditis recurrente secundaria a dicho proceso

Juvenile recurrent parotitis may have many causative factors. It is important to make an study of lymphocyte subsets, due to natural killer cells deficiency could be pathogenic. The clinical case of a 10-year-old patient with recurrent parotitis secondary to this process is presented

Surgical Treatment of Chronic Parotitis

Abstract Introduction chronic parotitis (CP) is a hindering, recurring inflammatory ailment that eventually leads to the destruction of the parotid gland. When conservative measures and sialendoscopy fail, parotidectomy can be indicated. Objective to evaluate the efficacy and safety of parotidectomy as a treatment for CP unresponsive to conservative therapy, and to compare superficial and near-total parotidectomy (SP and NTP). Methods retrospective consecutive case series of patients who underwent parotidectomy for CP between January 1999 and May 2012. The primary outcome variables were recurrence, patient contentment, transient and permanent facial nerve palsy and Frey syndrome. The categorical variables were analyzed using the two-sided Fisher exact test. Alongside, an elaborate review of the current literature was conducted. Results a total of 46 parotidectomies were performed on 37 patients with CP. Neartotal parotidectomy was performed in 41 and SP in 5 cases. Eighty-four percent of patients was available for the telephone questionnaire (31 patients, 40 parotidectomies) with a mean follow-up period of 6,2 years. Treatment was successful in 40/46 parotidectomies (87%) and 95% of the patients were content with the result. The incidence of permanent and transient facial nerve palsy was 0 (0%) and 12 (26.1%), respectively. Frey syndrome manifested in 20 (43.5%) patients. Neither this study nor careful review of the current literature resulted in evident difference between SP and NTP regarding the primary outcome variables. Conclusion parotidectomy is a safe and effective treatment for CP in case conservative therapy fails. There is no evidence of a distinct difference between SP and NTP regarding efficiency, facial nerve palsy or Frey syndrome. (AU)

Parotiditis crónica recurrente juvenil / Infantile recurrent parotitis

La parotiditis crónica recurrente es una patología que cursa con inflamación parotídea unilateral o bilateral. Afecta a edades pediátricas y tiende a desaparecer con la edad. El objetivo es presentar esta patología infrecuente que, sin embargo, es de fácil diagnóstico y manejo de forma ambulatoria. Se presentan dos casos de esta patología de nuestro centro. Esta patología puede ser tratada de forma ambulatoria con analgesia, antiinflamatorios y, en caso de sobreinfección bacteriana, adjuntando antibioterapia. Las pruebas complementarias indicadas son la ecografía y la analítica sanguínea. Es una patología con buen pronóstico y tratamiento simple. Es importante realizar un buen diagnóstico diferencial. Suele desaparecer conforme el paciente se acerca a la edad adolecente (AU)

Infantile recurrent parotitis is a disease characterized by unilateral or bilateral parotid swelling. It appears in childhood and usually disappears during adolescence. The objective is to present this rare disease which has an easy treatment and diagnosis. We report two cases of this disease from our hospital. This condition can be treated with outpatient treatment, with analgesics, anti-inflammatory drugs and, if there is bacterial infection, also with antibiotics. As additional tests, blood tests and ultrasound are recommended. It is a disease with good prognosis and simple treatment. Differential diagnosis is very important. It usually disappears as the patient approaches the adolescence (AU)

Lesiones bucales en niños VIH/Sida y su relación con linfocitos CD4 y carga viral: Valencia / Mouth injuries in children with HIV/AIDS and their relation with CD4 limphocytes and viral load

El 90 por ciento de los pacientes VIH-SIDA presentan lesiones bucales durante el curso de la enfermedad, observándose en la mayoría de los niños en las etapas iniciales, lesiones muchas veces no imputables al VIH. Determinar las manifestaciones bucales y su relación con el porcentaje de linfocitos CD4 y la carga viral, en 40 niños VIH/SIDA que acudieron a la consulta de infectología y odontología pediátrica de la Ciudad Hospitalaria “Dr. Enrique Tejera”. A través de un estudio descriptivo y de campo, se analizaron las variables, edad, género, categoría clínico-inmunológica, manifestaciones en tejidos blandos y duros, porcentaje de linfocitos CD4 y carga viral. El grupo de niños más afectado fue el de 1 a 6 años y el género femenino. La categoría clínica inmunológica más frecuente fue la B2 y la C3. En 65 por ciento hubo caries y en 80 por ciento lesión de tejidos blandos. La lesión bucal más común fue: adenopatías 57.5 por ciento, seguida de candidiasis 30 por ciento, y en igual proporción (17,5 por ciento) afta-úlceras y gingivitis; parotiditis y xerostomía 12.5 por ciento, herpes oral y petequias 10 por ciento, queilitis 7.5 por ciento, leucoplasia vellosa y eritema gingival lineal 2.5 por ciento. Independientemente del porcentaje de CD4 y carga viral, se evidenciaron manifestaciones bucales en tejidos duros y blandos, en una frecuencia relativamente alta, de allí la imperiosa necesidad de institucionalizar los programas de atención odontológica, así como la instrucción, sensibilización y motivación a los padres, representantes y personal de salud en el área pediátrica, sobre la importancia de la salud bucal en los niños VIH/SIDA.

90 percent of the childrens infected with VIH-AIDS may be at increased risk of experiencing oral lesions during the course of the illness, principally at the initial stage, the most of these lesions were not associated to HIV. To determine the oral manifestations and their relation with the percentage of lymphocytes CD4 and the viral load, in 40 children being treated for HIV-infection of the Paediatric Infection and Dentistry Service at the “Ciudad Hospitalaria Dr. Enrique Tejera.”. By means of a descriptive study of field, the variables age, gender, immunological clinical category, soft and hard tissue manifestations, percentage of lymphocytes CD4, and viral load were analyzed. The childrens more affected were the group of 1 to 6 years old and in feminine gender. The most frequent immunological clinical category was the B2 and the C3. In 65 percent there was dental caries, and in 80 percent soft oral lesion. The most common oral manifestation was adenopaty 57,5 percent, followed of candidacies 30 percent, and in equal proportion 17.5 percent aphthous ulcerations, and gingival erythema, parotid en largement and xerostomia 12,5 percent, herpes oral and petechiae 10 percent, cheilitis 7,5 percent, hairy leukoplakia and gingival erythema linear 2.5 percent. Independently of percentage CD4 and the viral load, oral manifestations on hard tissue were recorded as much as in soft tissue. The hard and soft weave injuries were relatively high, consequently, the urgent necessity to institutionalize preventive and therapeutic dental program, and also the education, sensibilization and motivation to parents, representatives and health personnel in the paediatric area; about the importance of oral health in HIV/AIDS children.