RESUMO
The objective was to investigate the prevalence of temporomandibular dysfunction TMD - in severe and moderate hemophiliac A and B patients and healthy men as control group. Hemophilia complication is chronic arthropathy that results from repeated joint bleeding, leading to limited movement. Limitation of jaw movement is present in patients with TMD. Hemophiliac patients were recruited in the Hemophilia outpatient clinic at Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). The control group was composed of voluntary subjects recruited among medical and dental students of UNIFESP. Both groups were screened for TMD symptoms according to the European Academy of Craniomandibular Disorders questionnaire. The Research Diagnostic Criteria further evaluated those considered positive for TMD. The results showed a similar prevalence of TMD in the hemophiliac group compared to the control group (n= 38, n= 79; p= 0.7). There were no significant differences in severity of sign and symptoms between the groups. In conclusion, patients with hemophilia do not have a higher prevalence of temporomandibular disorders, indicating absence of hemorrhage in temporomandibular joint.
El objetivo fue investigar la prevalencia de trastornos temporomandibulares (TTM) entre pacientes hemofílicos A y B severos y moderados, y hombres sanos como grupo de control. Una complicación de la Hemofilia es la artropatía crónica como resultado de una hemorragia articular a repetición, limitando el movimiento en el tiempo. La limitación del movimiento de la mandíbula está presente en pacientes con TTM. Los pacientes hemofílicos fueron reclutados en la clínica de atención ambulatoria de hemofilia en Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). El grupo control estaba compuesto por sujetos voluntarios reclutados entre los estudiantes de Medicina y Odontología de UNIFESP. Ambos grupos fueron evaluados por síntomas de TTM según cuestionario de trastornos craneomandibulares de la Academia Europea. Los criterios de diagnósticos de investigación evaluados se consideraron positivos para TTM. Los resultados mostraron una prevalencia similar de TTM en el grupo de hemofílicos en comparación con el grupo control (n= 38, n= 79; p= 0,7). No se encontraron diferencias significativas en la gravedad de los signos y síntomas entre los grupos. En conclusión, los pacientes con hemofilia no tienen una mayor prevalencia de trastornos temporomandibulares, indicando la ausencia de hemorragia en la articulación temporomandibular.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Adulto Jovem , Transtornos da Articulação Temporomandibular/epidemiologia , Transtornos Herdados da Coagulação Sanguínea/complicações , Estudantes de Ciências da Saúde , Transtornos da Articulação Temporomandibular/diagnóstico , Transtornos da Articulação Temporomandibular/etiologia , Grupos Controle , Prevalência , Estudos Transversais , Inquéritos e Questionários , Hemofilia B/complicações , Hemofilia A/complicaçõesRESUMO
A known hemophiliac B male (blood coagulation factor IX level of 15 per cent), HIV negative, in whom a Philadelphia chromosome positive chronic myeloid leukemia developed at the age of 29 years, is presented. The leukemia was diagnosed after an upper digestive tract bleeding, due to a duodenal ulcer. Two years elapsed between the diagnosis of leukemia and the start of busulfan therapy. During that period and after the start of treatment, the hemorrhagic tendency did not increase. The follow up of the patient was almost 8 years, with favorable clinical response to busulfan therapy. The patient survived more than twice the average survival of chronic myeloid leukemia patients treated with busulfan. A reciprocal influence between chronic myeloid leukemia and hemophilia appears illustrated by this case report.