Periodontal manifestation of leukocyte adhesion deficiency type I.
BACKGROUND
Leukocyte adhesion deficiency type I (LAD-I) is an autosomal recessive immunodeficiency disorder characterized by defects in the integrin receptors of white blood cells that lead to impaired adhesion and chemotaxis. Affected patients are susceptible to recurrent bacterial and fungal infections, impaired pus formation, delayed wound healing, and periodontitis.


METHODS
A case of generalized advanced periodontal destruction of the permanent and deciduous dentition in a young Jordanian girl with a severe phenotype of LAD-I is presented in this report. The medical diagnosis was made based on the characteristic clinical and laboratory findings, in particular the total absence of CD18, CD11b, and CD11c as determined by flow cytometry sorting.


RESULTS
Periodontal findings in this patient include the early onset of the disease, which affected the primary teeth and permanent dentitions, the intense redness and inflammation of the gingiva, and the rapid periodontal destruction that seems refractory to conventional non-surgical periodontal therapy.


CONCLUSIONS
This report emphasizes the importance of the differential diagnosis of severe immunodeficiency disorders in children and adolescents and mandates the importance of combined care by medical and dental practitioners to prevent tooth loss and control oral infection.
Dababneh
Reem
R
Dental Department, Prince Rashid Bin Al-Hassan Hospital/Royal Medical Services, Irbid, Jordan.
Al-Wahadneh
Adel M
AM
Hamadneh
Shamekh
S
Khouri
Antwan
A
Bissada
Nabil F
NF
D016301:Alveolar Bone Loss / Q000209:etiology; D039481:CD11b Antigen / Q000032:analysis; D039521:CD11c Antigen / Q000032:analysis; D018821:CD18 Antigens / Q000032:analysis; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005889:Gingival Recession / Q000209:etiology; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D018370:Leukocyte-Adhesion Deficiency Syndrome / Q000150:complications*; D017622:Periodontal Attachment Loss / Q000209:etiology; D010510:Periodontal Diseases / Q000209:etiology*; D010518:Periodontitis / Q000209:etiology; D014086:Tooth Mobility / Q000209:etiology; D014094:Tooth, Deciduous / Q000473:pathology
D039481:CD11b Antigen; D039521:CD11c Antigen; D018821:CD18 Antigens; C509295:ITGAM protein, human