Severe periodontal disease associated with long-term treatment with intravenous immunoglobulin.
Intravenous immunoglobulin (IVIG) is used in the treatment of neuropathy. This case report presents, for the first time, a patient with severe periodontal destruction after chronic therapy with IVIG. The patient reported having extracted his maxillary anterior teeth himself due to high mobility. Clinical examination and radiographic images show a generalized and severe periodontitis. No significant alterations in genetic or microbiological features were observed. The present case suggests that periodontal disease aggravation could be considered a new adverse effect of IVIG therapy. Postulated mechanisms are immune complexes formation, complement activation, and a direct effect in osteoclasts. In conclusion, it is important that patients that will receive IVIG treatment underwent dental evaluation.
Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, 31270-901 Belo Horizonte, MG, Brazil.
Jôice Dias
JD
Corrêa
Special Service for Diagnosis and Treatment in Dentistry (SEDTO), Hospital and Clinics, Federal University of Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil.
Amanda Leal
AL
Rocha
Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, 31270-901 Belo Horizonte, MG, Brazil.
Lidiane Cristina Machado
LC
Costa
Special Service for Diagnosis and Treatment in Dentistry (SEDTO), Hospital and Clinics, Federal University of Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil ; Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, 31270-901 Belo Horizonte, MG, Brazil.
Denise
D
Travassos
Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, 31270-901 Belo Horizonte, MG, Brazil ; Special Service for Diagnosis and Treatment in Dentistry (SEDTO), Hospital and Clinics, Federal University of Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil.
Wagner Henriques
WH
Castro
Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, 17012-901 Bauru, SP, Brazil.
Gustavo Pompermaier
GP
Garlet
Neurology Service, Hospital and Clinics, Federal University of Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil.
Rodrigo Santiago
RS
Gomez
Neurology Service, Hospital and Clinics, Federal University of Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil.
Antônio Lúcio
AL
Teixeira
Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, 31270-901 Belo Horizonte, MG, Brazil ; Special Service for Diagnosis and Treatment in Dentistry (SEDTO), Hospital and Clinics, Federal University of Minas Gerais, 30130-100 Belo Horizonte, MG, Brazil.
Tarcília Aparecida
TA
Silva