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MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU

Year 2015, Supplement 10, 46 - 50, 21.05.2015
https://doi.org/10.17567/dfd.93639

Abstract

ÖZET

Multipl myeloma (MM), plazma hücrelerinin kemik iliğinde anormal immunoglobulin (Ig) üretmeleri ile karakterize malign bir hastalıktır. Klinik olarak, tekrarlayan bakteriyel enfeksiyonlar, anemi, böbrek yetmezliği ve kemik iliğinde litik lezyonlar görülmekte- dir. MM olgularının %5-30’unda çenelerde belirtiler rapor edilmiştir. Bu nedenle MM hastalarında dental yaklaşım oldukça önemlidir.

Bu vaka raporunun amacı, kemik iliği transp- lantasyonu (KİT) ve kemoterapi planlanan MM tanılı 30 yaşında bir erkek hastanın teşhisinde kullanılan görün- tüleme yöntemlerinin ve tedavisinin sunulmasıdır.

MM hastalarında kemik iliği transplantasyon- larının başarısı, fokal enfeksiyon odakları ile ilişkili olabilmektedir. Dolayısıyla, bu hastalar kemik iliği transplan- tasyonu öncesi dental açıdan dikkatli bir şekilde değerlendirilmelidirler.

Anahtar Kelimeler: Multipl Myeloma, Fokal Enfeksiyon

DENTAL MANAGEMENT OF A MULTIPLE MYELOMA PATIENT: A CASE REPORT

ABSTRACT

Multiple myeloma (MM) is a malign disease characterized by production of abnormal immunoglobulin (Ig) in the bone marrow. Clinical features include recurrent bacterial infections, anemia, renal failure and osteolytic bone lesions. 5-30% of myeloma patients have been reported with jaw involvement. Therefore, the dental management of MMs has obvious clinical importance.

The aim of this case report is to present diagnostic imaging techniques and treatment of a 30-year-old man diagnosed with MM who is considering bone marrow transplantation (BMT) and chemotherapy.

The success of bone marrow transplantation in MM patients may be associated with dental foci, therefore this patient must be carefully evaluated orally before bone marrow transplantation.

Keywords: Multiple Myeloma, Focal Infection


References

  • Yildirim M, Yildiz M, Duman E, Goktas S, Kaya V. Prognostic importance of the nutritional status and systemic inflammatory response in non-small cell lung cancer. J BUON. 2013;18:728-32.
  • Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR. Reviewof 1027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proc 2003;78:21- 33.
  • Lemaire M, Deleu S, de Bruyne E, van Valckenborgh E, Menu E, Vanderkerken K. The microenvironment and molecular biology of the multiple myeloma tumor. Adv. Cancer Res 2012; 110:19-42.
  • Narquin S, Ingrand P, Azais I, Delwail V, Vialle R, Boucecbi S, Tasu JP. Comparison of whole-body diffusion MRI and conventional radiological assessment in the staging of myeloma. Diagn Interv Imaging 2013;94:629-36.
  • Bersagel D. The incidence and epidemiology of plasma cell neoplasms. Stem Cells 1995; 12:1-9.
  • Lae ME, Vencio EF, Inwards CY, Unni KK, Nascimento AG. Myeloma of the jaw bones: a clinicopathologic study of 33 cases. Head Neck 2003;25:373-81.
  • Blomgren J, Back H. Oral hairy leukoplakia in a patient with multiple myeloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:408-10.
  • Perusse R. Oral candidiasis and multiple myeloma: An unusual association. Oral Surg Oral Med Oral Pathol 1994;78:264-6.
  • Eby C, Blinder M. Haemostatic complications associated with paraproteinemias. Curr Hematol Rep 2003;2:388-94.
  • Kraj M, Owczarska K, Sokołowska U, Centkowski P, Pogłód R, Kruk B. Correlation of osteoprotegerin and sRANKL concentrations in serum and bone marrow of multiple myeloma patients. Arch Immunol Ther Exp (Warsz). 2005;53:454-64.
  • Stoopler ET, Vogl DT, Stadtmauer EA. Medical management update: multiple myeloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:599-09.
  • Epstein JB, Voss NJ, Stevenson-Moore P. Maxillofacial manifestations of multiple myeloma: An unusual case and review of the literature. Oral Surg Oral Med Oral Pathol 1984;57:267-71.
  • Lee SH, Huang JJ, Pan WL, Chan CP. Gingival mass as the primary manifestation of multiple myeloma. Oral Surg Oral Med Oral Pathol 1996; 82:75-9.
  • Rolston KV. The Infectious Diseases Society of America 2002 guidelines for the use of antimicrobial agents in patients with cancer and neutropenia: salient features and comments. Clin Infect Dis 2004;39(Supp 1):44-8.
  • Shibata M, Kodani I, Doi R, Takubo K, Kidani K, Sakai H, Sonoda M, Ryoke K. Multiple myeloma presenting symptoms in the oral and maxillofacial region. Yonago Acta Med 2003;46:77–81.
  • Boccodoro M, Pileri A. Diagnosis prognosis and standart treatment of multiple myeloma. Hematol Oncol Clinic North America 1997;11:111-31.
  • Susanne L, Jacky WJR, Sandra C, Emmeline K, Wim JGO, Reinier A. Role of radiography, MRI and FDG-PET/CT therapeutical evaluation of patients with multiple myeloma Ann Hematol 2009;88: 1161–8. and
  • Shimamoto H, Tatsumi M, Kakimoto N, Hamada S, Shimosegawa E, Murakami S, Furukawa S, Hatazawa J. (18)F-FDG accumulation in the oral cavity is associated with periodontal disease and apical periodontitis: an initial demonstration on PET/CT. Ann Nucl Med 2008; 22:587-93.
  • Healy CF, Murray JG, Eustace SJ, Madewell J, O'Gorman PJ, O'Sullivan P. Multiple Myeloma: A Review of Imaging Features and Radiological Techniques. Bone Marrow Res 2011; doi: 10.1155/2011/583439.
  • Akarslan ZZ, Kahraman SA. Kemik Metastazı Yapmış Prostat Kanseri Tedavisinde Kullanılan Bifosfonata Bağlı Olarak Çene Kemiklerinde Gelişen Osteonekroz: Vaka Raporu Ve Literatür Derlemesi. Atatürk Üniv Diş Hek Fak Derg 2008;18:105-10.
  • Biçer AZY. Bifosfonatlar ve çenelerde görülen osteonekroz. Acta Odontol Turc 2013; 30:35-8.
  • Smiley S, Almyroudis N, Segal BH. Epidemiology and management of opportunistic infections in immunocompromised patients with cancer. Abstr Hematol Oncol 2005;8:20-30.
  • Delilbaşı AE. Onkolojik tedavi gören çocuklarda ağız ve diş sağlığı. Acta Odontol Turc 2013;30:39- 43.
  • Epstein JB, Stevenson-Moore P. Periodontal disease and periodontal management in patients with cancer. Oral Oncol 2001;37:613–9.
  • Mawardi H, Cutler C, Treister N. Medical management update: Non-Hodgkin lymphoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:19-33.
  • Gupta A, Epstein JB, Cabay RJ. Bleeding disorders of importance in dental care and related patient management. J Can Dent Assoc 2007;73:77-83.
  • Lockhart PB, Gibson J, Leitch J. Dental manangement considerations for the patients with an acquired coagulopathy. Part 2: Coagulopathies from drugs. Br. Dent J 2003;195:495-01.

DENTAL MANAGEMENT OF A MULTIPLE MYELOMA PATIENT: A CASE REPORT

Year 2015, Supplement 10, 46 - 50, 21.05.2015
https://doi.org/10.17567/dfd.93639

Abstract

Multiple myeloma (MM) is a malign disease production characterized immunoglobulin (Ig) in the bone marrow. Clinical features include recurrent bacterial infections, anemia, renal failure and osteolytic bone lesions. 5-30% of myeloma patients have been reported with jaw involvement. Therefore, the dental management of MMs has obvious clinical importance

References

  • Yildirim M, Yildiz M, Duman E, Goktas S, Kaya V. Prognostic importance of the nutritional status and systemic inflammatory response in non-small cell lung cancer. J BUON. 2013;18:728-32.
  • Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A, Fonseca R, Rajkumar SV, Offord JR, Larson DR, Plevak ME, Therneau TM, Greipp PR. Reviewof 1027 patients with newly diagnosed multiple myeloma. Mayo Clinic Proc 2003;78:21- 33.
  • Lemaire M, Deleu S, de Bruyne E, van Valckenborgh E, Menu E, Vanderkerken K. The microenvironment and molecular biology of the multiple myeloma tumor. Adv. Cancer Res 2012; 110:19-42.
  • Narquin S, Ingrand P, Azais I, Delwail V, Vialle R, Boucecbi S, Tasu JP. Comparison of whole-body diffusion MRI and conventional radiological assessment in the staging of myeloma. Diagn Interv Imaging 2013;94:629-36.
  • Bersagel D. The incidence and epidemiology of plasma cell neoplasms. Stem Cells 1995; 12:1-9.
  • Lae ME, Vencio EF, Inwards CY, Unni KK, Nascimento AG. Myeloma of the jaw bones: a clinicopathologic study of 33 cases. Head Neck 2003;25:373-81.
  • Blomgren J, Back H. Oral hairy leukoplakia in a patient with multiple myeloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:408-10.
  • Perusse R. Oral candidiasis and multiple myeloma: An unusual association. Oral Surg Oral Med Oral Pathol 1994;78:264-6.
  • Eby C, Blinder M. Haemostatic complications associated with paraproteinemias. Curr Hematol Rep 2003;2:388-94.
  • Kraj M, Owczarska K, Sokołowska U, Centkowski P, Pogłód R, Kruk B. Correlation of osteoprotegerin and sRANKL concentrations in serum and bone marrow of multiple myeloma patients. Arch Immunol Ther Exp (Warsz). 2005;53:454-64.
  • Stoopler ET, Vogl DT, Stadtmauer EA. Medical management update: multiple myeloma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:599-09.
  • Epstein JB, Voss NJ, Stevenson-Moore P. Maxillofacial manifestations of multiple myeloma: An unusual case and review of the literature. Oral Surg Oral Med Oral Pathol 1984;57:267-71.
  • Lee SH, Huang JJ, Pan WL, Chan CP. Gingival mass as the primary manifestation of multiple myeloma. Oral Surg Oral Med Oral Pathol 1996; 82:75-9.
  • Rolston KV. The Infectious Diseases Society of America 2002 guidelines for the use of antimicrobial agents in patients with cancer and neutropenia: salient features and comments. Clin Infect Dis 2004;39(Supp 1):44-8.
  • Shibata M, Kodani I, Doi R, Takubo K, Kidani K, Sakai H, Sonoda M, Ryoke K. Multiple myeloma presenting symptoms in the oral and maxillofacial region. Yonago Acta Med 2003;46:77–81.
  • Boccodoro M, Pileri A. Diagnosis prognosis and standart treatment of multiple myeloma. Hematol Oncol Clinic North America 1997;11:111-31.
  • Susanne L, Jacky WJR, Sandra C, Emmeline K, Wim JGO, Reinier A. Role of radiography, MRI and FDG-PET/CT therapeutical evaluation of patients with multiple myeloma Ann Hematol 2009;88: 1161–8. and
  • Shimamoto H, Tatsumi M, Kakimoto N, Hamada S, Shimosegawa E, Murakami S, Furukawa S, Hatazawa J. (18)F-FDG accumulation in the oral cavity is associated with periodontal disease and apical periodontitis: an initial demonstration on PET/CT. Ann Nucl Med 2008; 22:587-93.
  • Healy CF, Murray JG, Eustace SJ, Madewell J, O'Gorman PJ, O'Sullivan P. Multiple Myeloma: A Review of Imaging Features and Radiological Techniques. Bone Marrow Res 2011; doi: 10.1155/2011/583439.
  • Akarslan ZZ, Kahraman SA. Kemik Metastazı Yapmış Prostat Kanseri Tedavisinde Kullanılan Bifosfonata Bağlı Olarak Çene Kemiklerinde Gelişen Osteonekroz: Vaka Raporu Ve Literatür Derlemesi. Atatürk Üniv Diş Hek Fak Derg 2008;18:105-10.
  • Biçer AZY. Bifosfonatlar ve çenelerde görülen osteonekroz. Acta Odontol Turc 2013; 30:35-8.
  • Smiley S, Almyroudis N, Segal BH. Epidemiology and management of opportunistic infections in immunocompromised patients with cancer. Abstr Hematol Oncol 2005;8:20-30.
  • Delilbaşı AE. Onkolojik tedavi gören çocuklarda ağız ve diş sağlığı. Acta Odontol Turc 2013;30:39- 43.
  • Epstein JB, Stevenson-Moore P. Periodontal disease and periodontal management in patients with cancer. Oral Oncol 2001;37:613–9.
  • Mawardi H, Cutler C, Treister N. Medical management update: Non-Hodgkin lymphoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:19-33.
  • Gupta A, Epstein JB, Cabay RJ. Bleeding disorders of importance in dental care and related patient management. J Can Dent Assoc 2007;73:77-83.
  • Lockhart PB, Gibson J, Leitch J. Dental manangement considerations for the patients with an acquired coagulopathy. Part 2: Coagulopathies from drugs. Br. Dent J 2003;195:495-01.
There are 27 citations in total.

Details

Primary Language Turkish
Subjects Dentistry
Journal Section Articles
Authors

Nihat Demirtaş

Emre Aytuğar This is me

H. Oğuz Kazancıoğlu This is me

Ezgi Erdoğan This is me

Publication Date May 21, 2015
Published in Issue Year 2015 Supplement 10

Cite

APA Demirtaş, N., Aytuğar, E., Kazancıoğlu, H. O., Erdoğan, E. (2015). MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 25, 46-50. https://doi.org/10.17567/dfd.93639
AMA Demirtaş N, Aytuğar E, Kazancıoğlu HO, Erdoğan E. MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU. Ata Diş Hek Fak Derg. May 2015;25:46-50. doi:10.17567/dfd.93639
Chicago Demirtaş, Nihat, Emre Aytuğar, H. Oğuz Kazancıoğlu, and Ezgi Erdoğan. “MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 25, May (May 2015): 46-50. https://doi.org/10.17567/dfd.93639.
EndNote Demirtaş N, Aytuğar E, Kazancıoğlu HO, Erdoğan E (May 1, 2015) MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 25 46–50.
IEEE N. Demirtaş, E. Aytuğar, H. O. Kazancıoğlu, and E. Erdoğan, “MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU”, Ata Diş Hek Fak Derg, vol. 25, pp. 46–50, 2015, doi: 10.17567/dfd.93639.
ISNAD Demirtaş, Nihat et al. “MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 25 (May 2015), 46-50. https://doi.org/10.17567/dfd.93639.
JAMA Demirtaş N, Aytuğar E, Kazancıoğlu HO, Erdoğan E. MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU. Ata Diş Hek Fak Derg. 2015;25:46–50.
MLA Demirtaş, Nihat et al. “MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, vol. 25, 2015, pp. 46-50, doi:10.17567/dfd.93639.
Vancouver Demirtaş N, Aytuğar E, Kazancıoğlu HO, Erdoğan E. MULTİPLE MYELOMALI HASTADA DENTAL YAKLAŞIM: OLGU SUNUMU. Ata Diş Hek Fak Derg. 2015;25:46-50.

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