Immunological diseases Flashcards
List components of innate immunity
- Phagocytic cells
- Complement
- Natural barriers such as skin, enzymes in tears etc
List components of adaptive immunity
- T cells
- B cell
When does immunodeficiency occur
When one or more components of the immune system are defective of absent
How can immunodeficiency be classified
- Primary/ inherited immunodeficiency
- Secondary/ acquired immunodeficiency
Which cells can be lacking in primary/ inherited immunodeficiency
- B cells
- T cells
- Combined B and T cells
- Neutrophils
- Complement
What can secondary/ acquired immunodeficiency be caused by
- Infections
- Lymphoproliferative disease
- Malnutrition
- Immunosuppressive drugs
What can immunodeficiency cause
- Infection
- Autoimmunity and malignancy
List some of the warning signs of immunodeficiency
- > 8 new ear infections in a yr
- > 2 serious sinus infections in a yr
- > 2 cases of pneumonia in a yr
- Recurrent deep skin or organ abcesses
- > 2 Deep seated infected
- Antibiotics for 2 months without effect
- Surgical intervention for chronic infection
- Persistent thrush in mouth or else where on the skin after age 1
- Failure to thrive
- Family history of immunodeficiency
Give examples of specific primary immunodeficiencies that may be seen in dental practice
- Common cartable immunodeficiency (CVID)
- Wiskott- Aldrich syndrome (WAS)
- Chronic mucocutaneous candidiasis (CMC)
- Chronic granulomatous disease (CGD)
- deficiency of C1 esterase inhibitor
What is Common cartable immunodeficiency (CVID) caused by
Cause unknown but thought to be due to multiple gene defects
What do patients with Common cartable immunodeficiency (CVID) present with
Recurrent bacterial infection and may present at any age
How do we treat Common cartable immunodeficiency (CVID)
Antibody replacement therapy
Who does Wiskott–Aldrich syndrome (WAS) affect
Classically affects men as it is an X linked disorder
What is Wiskott–Aldrich syndrome (WAS) associated with
Eczema
Low platelet counts
Recurrent infections
What are Wiskott–Aldrich syndrome (WAS) suffers at risk of in the dental setting
Bleeding following dental treatment
Will require antibiotic prophylaxis
What does Chronic mucocutaneous candidiasis (CMC) present with
chronic candidal infection of the skin and mucous membrane
May also have an autoimmune endocrine deficiency
How does Chronic granulomatous disease (CGD)
present
Present in childhood with recurrent deep abscesses
May also develop gingivitis and tooth loss
What is Chronic granulomatous disease (CGD)
due to
The underlying immunological defect is a failure of the neutrophil oxidative burst and subsequent killing of organisms.
What is Deficiency of C1 esterase inhibitor
Defects of the control protein C1 esterase inhibitor which may be inherited and result in uncontrolled activation of the complement pathway
What do patients with Deficiency of C1 esterase inhibitor present with
Recurrent deep quelling with exposure to minor trauma or stress such as dental tx
Can develop fatal laryngeal oedema
If you are aware a patent has an immunodeficiency what should you look out for upon examination
- Candidiasis
- Oral hairy leukoplakia
- Severe gingivitis
- Tooth loss
- Mouth ulceration
- Dry mouth
- Absent tonsils
- Skin changes
What can oral candida be caused by
- Antibiotic therapy
- Steroid inhalers
- Dentures
- Secondary immunodeficiency
- Connective tissue disease
- Primary immunodeficiency
What can mouth ulcers be caused by
- Aphthous
- Behçet’s syndrome
- SLE (systemic lupus erythematosus)
- Cancer
- Crohn’s disease
What can gingivitis and tooth loss be caused by
1 .Pregnancy
2. Ciclosporin
3. Scurvy
4. Anticonvulsants
5. Chronic granulomatous disease (primary immunodeficiency)
