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Paszynska E, Hernik A, Rangé H, Amaechi BT, Gross GS, Pawinska M. Diet Traps during Eating Disorders among Dentate Patients at an Oral Health Glance. Nutrients 2023; 15:4414. [PMID: 37892489 PMCID: PMC10610111 DOI: 10.3390/nu15204414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Persons suffering from eating disorders (ED) may often experience a recurrence/persistence symptoms despite the completion of psychiatric therapy. In most cases, their general health status is linked to current nutritional behaviors. Medical professionals, general practitioners (GPs), dieticians, and dentists may see those patients in their practices. At the same time, due to low sense of illness, some patients may delay or never seek professional medical care. The aim of this article is to analyze the main ED types according to dietary behaviors causing oral health problems and discuss oral health complications in affected dentate patients. The second objective is to update oral preventive measures and technological innovations together with active agents for oral hygiene care that might effectively support oral health maintenance during the presence of long-term symptoms. The research method involved a review of clinical reports as a synthesis of the electronic research in the Pubmed, Web of Science, and Google Scholar databases. Based on the research, ED patients were found to present related incidences of oral complications. Studies have reported that the possible course of an ED and comorbidities may be an imbalance in the oral environment. The results showed an association between biological (malnutrition, etc.), behavioral (binge eating episodes, vomiting, acidic diet, poor oral hygiene), and pharmacotherapeutic (addiction, hyposalivation) factors that may threaten oral health. Early diagnosis of the past and present symptoms is essential to eliminate and take control of destructive behaviors. Oral changes need to be tackled with medical insight, and additionally, the perception of dietary interactions is recommended.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), 60-812 Poznan, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), 60-812 Poznan, Poland
| | - Hélène Rangé
- Department of Periodontology, Faculty of Odontology, University of Rennes, CHU de Rennes, F-35000 Rennes, France
- Institut NUMECAN (Nutrition Metabolism and Cancer), INSERM, INRAE, University of Rennes, F-35000 Rennes, France
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Georgiana S. Gross
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University in Bialystok, 15-276 Bialystok, Poland
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Presskreischer R, Prado MA, Kuraner SE, Arusilor IM, Pike K. Eating disorders and oral health: a scoping review. J Eat Disord 2023; 11:55. [PMID: 37016387 PMCID: PMC10071677 DOI: 10.1186/s40337-023-00778-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/27/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Screening and treatment guidance for somatic sequalae of eating disorders typically include specifics such as laboratory testing, observable physical signs, and treatment interventions. Oral health guidance is notably sparse or absent from many guidelines. Often, the only mention of oral health is the potential erosion caused by self-induced vomiting and suggests a referral to an oral health professional. The guidelines generally do not include information about education and training of oral health professionals. OBJECTIVE The objective of this research was to explore the literature on eating disorders and oral health including the effects of eating disordered behaviors on oral health and training of oral health professionals to increase their capacity to recognize and appropriately address clinical care needs of individuals with eating disorders. METHODS A comprehensive scoping review was conducted to investigate what is known about the relationship between eating disorders and oral health and training provided to oral health professionals in recognition and treatment of individuals with eating disorders. The search was completed using PubMed, Embase, Science Direct, Google Scholar, and the Journal of the American Dental Association. RESULTS Of 178 articles returned in the initial search, 72 full texts were read, and 44 were included based on eligibility criteria. The retained articles were categorized thematically into articles related to (1) oral health professional education and training, (2) the oral health effects of eating disorders, and (3) patient experiences of oral health care. CONCLUSION Most of the research on the relationship between eating disorders and oral health examines the impact of eating disordered behaviors. There is a significantly smaller literature on the knowledge and training of oral health professionals related to eating disorders and individuals with eating disorders' experiences of oral health care. Research on education and training of oral health professionals should be expanded globally, taking into consideration the suitability of interventions for diverse models of oral health education and service delivery. Further, there is an opportunity for eating disorder professionals and professional organizations to improve understanding and care of eating disorders by building relationships with oral health providers and professional organizations in their local communities.
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Affiliation(s)
- Rachel Presskreischer
- Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th Street, New York, NY, 10032, USA.
| | - Michael A Prado
- Columbia University College of Dental Medicine, New York, NY, USA
| | | | - Isabelle-Maria Arusilor
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Kathleen Pike
- Department of Psychiatry, Columbia-WHO Center for Global Mental Health, Columbia University Irving Medical Center, New York, NY, USA
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Paszynska E, Hernik A, Slopien A, Roszak M, Jowik K, Dmitrzak-Weglarz M, Tyszkiewicz-Nwafor M. Risk of Dental Caries and Erosive Tooth Wear in 117 Children and Adolescents' Anorexia Nervosa Population-A Case-Control Study. Front Psychiatry 2022; 13:874263. [PMID: 35619622 PMCID: PMC9127314 DOI: 10.3389/fpsyt.2022.874263] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/06/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Restrictive type of anorexia nervosa (AN) is still one of the most severe eating disorders worldwide with an uncertain prognosis. Patients affected by AN should be encouraged to undertake psychiatric care and psychotherapy, but whether they should necessarily be included in careful dental care or not may still be questionable. Even though there is a constantly increasing number of AN studies, there are just a few data about the youngest group of AN children and adolescents aged < 18. METHODOLOGY This case-control study aimed to compare the dental health and gingival inflammation level in female adolescent inpatients affected by severe AN restrictive subtype vs. controls. Based on clinically confirmed 117 AN cases (hospitalized in years 2016-2020 in public Psychiatric Unit, BMI < 15 kg/m2, mean age 14.9 ± 1.8), the dental status has been examined regarding the occurrence of caries lesions using Decay Missing Filling Teeth (DMFT), erosive wear as Basic Erosive Wear Examination (BEWE), gingival condition as Bleeding on Probing (BOP) and plaque deposition as Plaque Control Record (PCR). The results were compared with age-matched 103 female dental patients (BMI 19.8 ± 2.3 kg/m2, age 15.0 ± 1.8, p = 0.746) treated in a public University dental clinic. RESULTS AN patients were found to present a higher incidence of oral-related complications according to dental status (DMFT 3.8 ± 4.5 vs. 1.9 ± 2.1, p = 0.005), erosive tooth wear (BEWE 18.9 vs. 2.9%, p < 0.001), less efficient in controlling plaque (PCR 43.8 vs. 13.7%, p < 0.001) and gingival inflammation (BOP 20.0 vs. 3.9%, p < 0.001) compared with female adolescents. In the AN group, a significant correlation between BOP, BEWE, and duration of AN disease (p < 0.05), similarly to the number of decayed teeth D, filled teeth F and PCR were detected (p < 0.05). CONCLUSIONS Although the obtained results did not reveal any severe oral status, our findings indicated impaired dental and gingival conditions in young anorexics. Considering AN's potential role in oral health, it is essential to monitor dental treatment needs and oral hygiene levels in their present status to prevent forward complications in the future.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznań, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznań, Poland
| | - Agnieszka Slopien
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Magdalena Roszak
- Department of Computer Sciences and Statistics, Poznan University of Medical Sciences, Poznań, Poland
| | - Katarzyna Jowik
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Monika Dmitrzak-Weglarz
- Department of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Marta Tyszkiewicz-Nwafor
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
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Rangé H, Colon P, Godart N, Kapila Y, Bouchard P. Eating disorders through the periodontal lens. Periodontol 2000 2021; 87:17-31. [PMID: 34463986 PMCID: PMC8637500 DOI: 10.1111/prd.12391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Hélène Rangé
- Department of Periodontology, Université de Paris, U.F.R. d'Odontologie-Garancière, Paris, France.,Service d'Odontologie, Hôpital Rothschild, AP-HP.Sorbonne Université, Paris, France.,UR 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Paris, France
| | - Pierre Colon
- Service d'Odontologie, Hôpital Rothschild, AP-HP.Sorbonne Université, Paris, France.,Department of Restorative Dentistry and Endodontics, U.F.R. d'Odontologie-Garancière, Université de Paris, Paris, France.,Laboratoire Multimatériaux et Interfaces, Université Claude Bernard Lyon 1, UMR CNRS, Villeurbanne, France
| | - Nathalie Godart
- Service Hospitalo-Universitaire de Santé Mentale pour les Adolescents et Jeunes Adultes, Fondation Santé des Etudiants de France, Paris, France.,U.F.R. Simone Veil, Université Versailles Saint Quentin en Yvelynes (UVERSUSQ), Montigny-Le-Bretonneux, France.,Centre de Recherche en Epidémiologie et Santé des Populations (CESP), Hôpital Paul Brousse, Villejuif, France
| | - Yvonne Kapila
- Department of Orofacial Sciences, University of California San Francisco, School of Dentistry, San Francisco, California, USA
| | - Philippe Bouchard
- Department of Periodontology, Université de Paris, U.F.R. d'Odontologie-Garancière, Paris, France.,Service d'Odontologie, Hôpital Rothschild, AP-HP.Sorbonne Université, Paris, France.,UR 2496 Laboratory of Orofacial Pathologies, Imaging and Biotherapies, Université de Paris, Paris, France
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Tamura A, Minami K, Tsuda Y, Mizumoto K, Suzuki H. Adolescent eating disorder with catheter-related bloodstream infection. Pediatr Int 2021; 63:678-684. [PMID: 33053266 DOI: 10.1111/ped.14511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 10/03/2020] [Accepted: 10/09/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Treatment of adolescent eating disorder requires early improvement of nutritional status. Central venous hyperalimentation is used but catheter-related bloodstream infection (CRBSI) is a complication. There have been no reports examining risk factors for CRSBI in eating disorders. METHODS The subjects were 51 patients who received nutritional therapy with the use of a peripherally inserted central catheter (PICC) from January 2012 to December 2019. The courses of weight and white blood cell (WBC) count were examined retrospectively during nutritional therapy. Onset factors for CRBSI were determined and a case series of CRBSI caused by Candida parapsilosis is presented. RESULTS The day of minimum weight occurred on or before day 7 in 37 of the 51 patients, and this day was preceded by the day with the lowest WBC at a significant rate. The minimum weight day was significantly delayed in CRSBI cases compared with non-CRBSI cases (P = 0.02). In the case series of CRBSI caused by C. parapsilosis, the median WBC count before CRBSI decreased to 2,570 (1,680-3,270)/μL at a median of day (12-90) 36. Catheter-related bloodstream infection developed at a median of day (26-133) 38. The PICC was immediately removed and an antifungal drug was started, leading to cure with no after effects in all subjects. CONCLUSIONS In patients with an eating disorder treated with nutritional therapy using a PICC, prolonged resistance to weight gain became a risk factor for developing CRBSI. White blood cell counts recover after weight gain, which suggests that there is a risk of developing CRBSI, even with improved appetite and weight gain.
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Affiliation(s)
- Akira Tamura
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Japan.,Department of Medical Safety Promotion, Wakayama Medical University, Wakayama City, Japan
| | - Koichi Minami
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Japan
| | - Yuko Tsuda
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Japan
| | - Kazuhiro Mizumoto
- Department of Medical Safety Promotion, Wakayama Medical University, Wakayama City, Japan
| | - Hiroyuki Suzuki
- Department of Pediatrics, Wakayama Medical University, Wakayama City, Japan
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Janczy A, Landowska M, Kochan Z. Gut microbiome dysbiosis in anorexia nervosa. POSTEP HIG MED DOSW 2021. [DOI: 10.5604/01.3001.0014.8601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Anorexia nervosa (AN) is described as an eating disorder, which is characterized by malnutrition,
a fear of gaining body mass, and a disturbed self-body image. This disease is dependent on biological,
psychological and socio-cultural factors. Among the various biological factors, the importance
of intestinal microbiota has recently attracted much attention. Identification of the gut microbiota
dysbiosis in patients with AN has opened new and promising research directions. Recent
observations focus in particular on the association between intestinal microorganisms and the
occurrence of functional gastrointestinal disorders associated with anorexia, anxiety and depression,
as well as the regulation of eating habits. The composition of the gut microbiota differs between
patients with AN and individuals with normal body mass. This is due to the incorrect diet
of patients; on the other hand, there is growing interest in the role of intestinal microbiota in the
pathogenesis of AN, its changes through re-nutrition practices, and in particular the modulation
of intestinal microbiological composition by means of nutritional interventions or the use of preand
probiotics as standard supplements therapy of eating disorders. There is a need for further
research about the microbiome - intestine - brain axis. Furthermore, consequences of changes in
dietary habits as part of AN treatment are also unknown. However, better knowledge about the
relationship between the gut microbiome and the brain can help improve the treatment of this
disorder. This review aims to present the current knowledge about the potential role of intestinal
microbiota in the pathogenesis, course and treatment of AN.
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Affiliation(s)
- Agata Janczy
- Zakład Biochemii Żywienia, Katedra Żywienia Klinicznego, Gdański Uniwersytet Medyczny
| | - Magdalena Landowska
- Zakład Biochemii Żywienia, Katedra Żywienia Klinicznego, Gdański Uniwersytet Medyczny
| | - Zdzisław Kochan
- Zakład Biochemii Żywienia, Katedra Żywienia Klinicznego, Gdański Uniwersytet Medyczny
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Esteves CV, Freitas RSD, Campos WGD, Shimabukuro N, Thomaz DY, Cordas T, Benard G, Witzel AL, Lemos CA. Oral yeast colonization in patients with eating disorders: commensal acquisition or due to purgative habits? Rev Inst Med Trop Sao Paulo 2020; 62:e32. [PMID: 32491142 PMCID: PMC7266616 DOI: 10.1590/s1678-9946202062032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 04/27/2020] [Indexed: 11/22/2022] Open
Abstract
Oral problems are common in patients diagnosed with Eating Disorders (ED) and still require better elucidation. We aimed to analyze the prevalence of oral Candida spp in individuals with ED. The sample of the study was comprised of 30 women with purgative habits and 15 without purgative habits. Samples of the oral cavity were collected by sterile cotton swab rubbed on soft tissues and teeth. Yeasts were isolated on Sabouraud dextrose agar. Yeasts were isolated from the oral cavity of 53% of the patients yielding 75 yeast isolates; of these, 43 were identified by conventional mycological methods: C. parapsilosis (n=19), C. glabrata (n=16), Rhodotorula sp (n= 6), C. famata (n=2). The remaining 32 isolates were presumptively identified as C. albicans or C. dubliniensis and required mass spectrometry for the final differentiation: 28 isolates were confirmed as C. albicans and four as C. dubliniensis. Among the control group, only four subjects (26.7%) were found to harbor C. albicans. The four C. dubliniensis isolates were from two patients, one that was only colonized and the other, with severe ED, was diagnosed with an oral candidiasis as demonstrated by the presence of pseudohyphae on the direct mycological exam from different sites. The increased rate of isolation of non-albicans species, such as C. glabrata, C. parapsilosis, and C. dubliniensis in the oral cavity from ED patients with nutritional deficiency may suggest that purgative habits of these patients can lead to changes in normal flora and predispose to oral candidiasis.
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Affiliation(s)
- Camilla Vieira Esteves
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Roseli Santos de Freitas
- Laboratório de Micologia Médica, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Wladimir Gushiken de Campos
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Natali Shimabukuro
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Danilo Yamamoto Thomaz
- Laboratório de Micologia Médica, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Taki Cordas
- Departamento e Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Gil Benard
- Laboratório de Micologia Médica, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Andrea Lusvarghi Witzel
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Celso Augusto Lemos
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, São Paulo, Brazil
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Paszynska E, Dutkiewicz A, Osinska A, Mozol-Jursza M, Smalc N, Tyszkiewicz-Nwafor M, Dmitrzak-Weglarz M, Slopien A, Jenerowicz D. Anorexia Nervosa with Vomiting Episodes: Dermatological and Oral Complications. Eur J Dent 2020; 14:180-185. [PMID: 32168544 PMCID: PMC7069751 DOI: 10.1055/s-0040-1705073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to highlight the aspect of oral and cutaneous changes in anorexia nervosa (AN) as a purging type. On the basis of three clinical cases, a description has been made of the beginning and the possible course of the disease, teeth, oral mucosa, and skin changes resulting from the illness. The research method was based on the analysis of the available literature on AN supplemented by clinical experience of presented cases. On the basis of the interdisciplinary analysis, it was concluded that the appropriate diagnosis and treatment of AN are possible only with the collaboration of many specialists—psychiatrist or pediatric psychiatrist, general practitioner, dermatologist, dentist, and if necessary other medical specialists. In this context, psychotherapy is an integral aspect of treatment. Therefore, early intervention is essential to obtain good results of treatment.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznań, Poland
| | - Agata Dutkiewicz
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Agata Osinska
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Marta Mozol-Jursza
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Natalia Smalc
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Marta Tyszkiewicz-Nwafor
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Monika Dmitrzak-Weglarz
- Department of Psychiatry, Psychiatric Genetics Unit, Poznan University of Medical S ciences, Poznań, Poland
| | - Agnieszka Slopien
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznań, Poland
| | - Dorota Jenerowicz
- Department and Clinic of Dermatology, Poznan University of Medical Sciences, Poznań, Poland
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Cardenas PA, Cookson WO. The Microbiome at Other Mucosal Sites. Mucosal Immunol 2015. [DOI: 10.1016/b978-0-12-415847-4.00006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nagao Y, Hashimoto K, Sata M. Candidiasis and other oral mucosal lesions during and after interferon therapy for HCV-related chronic liver diseases. BMC Gastroenterol 2012; 12:155. [PMID: 23122361 PMCID: PMC3503792 DOI: 10.1186/1471-230x-12-155] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 10/31/2012] [Indexed: 01/05/2023] Open
Abstract
Background Oral lichen planus (OLP) is seen frequently in patients with hepatitis C virus (HCV) infection. The aim of this study was to evaluate the occurrence of oral candidiasis, other mucosal lesions, and xerostomia during interferon (IFN) therapy for HCV infection. Methods Of 124 patients with HCV-infected liver diseases treated with IFN therapy in our hospital, 14 (mean age 56.00 ± 12.94 years) who attended to receive administration of IFN once a week were identified and examined for Candida infection and other oral lesions and for the measurement of salivary flow. Serological assays also were carried out. Results Cultures of Candida from the tongue surfaces were positive in 7 (50.0%) of the 14 patients with HCV infection at least once during IFN therapy. C. albicans was the most common species isolated. The incidence of Candida during treatment with IFN did not increase above that before treatment. Additional oral mucosal lesions were observed in 50.0% (7/14) of patients: OLP in three (21.4%), angular cheilitis in three (21.4%) and recurrent aphthous stomatitis in one (7.1%). OLP occurred in one patient before treatment with IFN, in one during treatment and in one at the end of treatment. 85.7% of the oral lesions were treated with topical steroids. We compared the characteristics of the 7 patients in whom Candida was detected at least once during IFN therapy (group 1) and the 7 patients in whom Candida was not detected during IFN therapy (group 2). The prevalence of oral mucosal lesions (P=0.0075) and incidence of external use of steroids (P=0.0308) in group 1 were significantly higher than in group 2. The average body weight of group 1 decreased significantly compared to group 2 (P=0.0088). Salivary flow decreased in all subjects throughout the course of IFN treatment and returned at 6th months after the end of treatment. In group 1, the level of albumin at the beginning of the 6th month of IFN administration was lower than in group 2 (P=0.0550). According to multivariate analysis, one factor, the presence of oral mucosal lesions, was associated with the detection of Candida. The adjusted odds ratio for the factor was 36.00 (95% confidence interval 2.68-1485.94). Conclusion We should pay more attention to oral candidiasis as well as other oral mucosal lesions, in patients with weight loss during IFN treatment.
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Affiliation(s)
- Yumiko Nagao
- Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
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