title: Extreme tooth abnormalities and treatment under general anesthesia in a child with chronic GVHD surviving relapse of acute lymphoblastic leukemia.
abstract: 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.
authors.affiliation: Department of Dental Anesthesiology, Okayama University Hospital, Japan. maedas@md.okayama-u.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Maeda
authors.forename: Michiyo
authors.initials: M
authors.lastname: Suda
authors.forename: Minako
authors.initials: M
authors.lastname: Ishii
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Tomoyasu
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Higuchi
authors.forename: Yoshihide
authors.initials: Y
authors.lastname: Okazaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Egusa
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyawaki
mesh_terms: D000015:Abnormalities, Multiple / Q000209:etiology; D000402:Airway Obstruction / Q000209:etiology; D000766:Anesthesia, Dental / Q000009:adverse effects / Q000379:methods*; D000768:Anesthesia, General / Q000009:adverse effects; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002908:Chronic Disease; D003731:Dental Caries / Q000209:etiology / Q000628:therapy; D003793:Dental Restoration, Permanent; D006086:Graft vs Host Disease / Q000150:complications* / Q000209:etiology; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D012008:Recurrence; D014071:Tooth Abnormalities / Q000209:etiology*; D014916:Whole-Body Irradiation / Q000009:adverse effects*