Leczenie stomatologiczne w zapobieganiu i terapii nawrotu zespołu nerczycowego u dzieci. Opis dwóch przypadków

© Borgis - Nowa Stomatologia 2/2012, s. 69-74

*Dorota Olczak-Kowalczyk¹, Małgorzata Pańczyk-Tomaszewska², Anna Piróg¹, Małgorzata Mizerska-Wasiak², Maria Roszkowska-Blaim²

Summary
Nephritic syndrome (a clinical condition with proteinuria above 50 mg/kg/day), is characterized by recurrences, which can be caused by bacterial and viral infections, and exacerbated by hyperlipidemia and glucocorticoid therapy. An important element of recurrence prevention is avoiding infection, and treatment – the elimination of foci of infection, which could be located in the mouth.
This study describes the cases of two boys with relapsing nephritic syndrome (9 and 4 years), including the process of diagnosing the foci of infection in the oral cavity, the nephrological and dental treatment, and its effectiveness.
In both cases lichenoid changes and erythema of oral mucosa, gingivitis and the presence of periopathogens responsible for the general inflammationwere observed, in the 9-year-old – gingival hyperplasia after cyclosporin usage, and in the 4-year-old – erosions on the mucosa. Due to the glucocorticosteroid theraphy (risk of new, and masking of current infections) antibiotic therapy consistent with antibiogram was used, and was effective in the 4-year-old boy. Treatment in the 9-year-old achieved change in the spectrum with the elimination of a the strain of bacteria causing periodontitis. In both patients sanitation of oral cavity was performed. Patients remain in remission of nephritic syndrome.

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