Causes for primary immunodeficiencies

2. Causes for primary immunodeficiencies X linked agammaglobulinaemia X linked hypogammaglobulinaemia Immunoglobulin deficiency with increased IgM Immunoglobulin heavy chain gene deletion Kappa chain deficiency Common variable immunodeficiency IgA deficiency Transient hypogammaglobulinaemia of infancy Selective IgG subclass deficiency

3. Combined immunodeficiency Severe combined immunodeficiency  Adenosine deaminase deficiency  Purine nucleoside deficiency  Major histocompatibility complex (MHC)ii deficiency  Reticular disgenesis

4. Hereditary Hemorrhagic Telangiectasia (Rendu-Osler-Weber Disease) - Autosomal dominant- tend to undergo repeated hemorrhage- Epistaxis may be an early sign- Pt. may suffer from anemia, but not usually life threatening.

5. Secondary Immunodeficiency Conditions · Infections HIV Acute severe viral infections Drug induced Immunosuppressive drugs  Cytotoxic drugs  Radiotherapy

6. Pseudomembranous Candidiasis

7. Esophageal Candidiasis

8. Hyperplastic Candidiasis

9. Periodontitis

10. Idiopathic Necrotizing Stomatitis • Consider: • Bacterial • Viral • Fungal • Combination Silverman, Eversole, Truelove. Essentials of Oral Medicine. London, B.C. Decker, 2001.

11. Aphthous Ulcer

12. Erythemathous Candidiasis

13. Linear Gingival Erythema

14. Lymphoepithelial Cyst

15. Angular Candidiasis

16. HSV Labialis

17. Intra-oral Herpes

18. Minor Aphthous Ulcers Silverman, Eversole, Truelove. Essentials of Oral Medicine. London, B.C. Decker, 2001.

19. Coccidiomycosis

20. Myelo- or lymphoproliferativedisordes  Myeloma  Leukaemias  Hodgkin’s and non Hodgkin’s lymphomas Metabolic disorders Malnutrition  Iron deficiency  Diabetes mellitus Autoimmune diseases SLE ITP Systemic scleroderma

21. Black hairy tongue.

22. Geographic tongue.

23. Fissured tongue.

24. Pernicious Anemia Pernicious anemia is a condition in which the body does not absorb vitamin B12. People who have this condition show signs of anemia, weakness, pallor, and fatigue on exertion. Other signs can include nausea, diarrhea, abdominal pain, and loss of appetite. The oral manifestations of pernicious anemia include angular cheilitis (ulceration and redness at the corners of the lips), mucosal ulceration, loss of papillae on the tongue, and a burning and painful tongue.

25. Iron deficiency. The tongue is devoid of filiform papillae. Angular cheilitis was also present in this patient.

26. Diseases of the Oral Soft Tissues

27. Leukoplakia.

28. Lichen planus.

29. Erythematous candidiasis.

30. Minor aphthous ulcer.

31. Cellulitis.

32. Leukemia.

33. HIV-Associated Periodontitis • HIV-associated periodontis resembles acute necrotizing ulcerative gingivitis superimposed on rapidly progressive periodontitis. • Other symptoms include: • Interproximal necrosis and cratering • Marked swelling • Intense erythema over the free and attached gingiva • Intense pain • Spontaneous bleeding and bad breath

34. Atypical periodontal disease in a patient with HIV infection.

35. HIV Cervical Lymphadenopathy Enlargement of the cervical (neck) nodes. Lymphadenopathy is frequently seen in association with AIDS.

36. HIV lymphoma.

37. Hairy Leukoplakia

38. Kaposi's Sarcoma

39. Herpes Simplex

40. Human Papilloma Viruses

42. An immunologically mediated condition that presents in one of serval forms, and affects skin, CT and specific internal organs

43. Salivary Dysfunction & Xerostomia Salivary Hypofunction/ Dry mouth Dry mouth (xerostomia) occurs when the salivary glands are not functioning properly resulting in decreased saliva. Saliva not only aids in digestion, but is a necessary factor in oral health because it also helps to keep your mouth moist and prevent tooth decay. Diabetic neuropathy can also affect the salivary glands. Polyuria Topical treatments: fluoride containing mouthrinses salivary substitutes

44. Oral Candidiasis • Opportunistic fungal infection commonly associated with hyperglycemia. • Salivary dysfunction compromise immune function. • Salivary hyperglycemia provide substrate for fungal growth

45. Burning Mouth Syndrome Burning mouth syndrome is a condition with no determined cause and is characterized by a chronic burning pain in your mouth. This burning sensation can be severe, feeling much the same as scalding and can affect the overall areas of your mouth such as your tongue, gums, lips, inside of your cheeks, and the roof of your mouth. Although BMS has no known cause and finding treatment may by difficult, most people can bring it under control by working with an oral health specialist.

46. Oral manifestations of patients with hypothyroidism -delayed eruption, -enamel hypoplasia in both dentitions, -anterior open bite, -macroglossia, -micrognathia, -thick lips, -dysgeusia, -mouth breathing.

47. Oral manifestations of patients with hyperparathyroidism • 1. Dental abnormalities: -widened pulp chambers; -development defects; -alterations in dental eruption -weak teeth -maloclussions • 2. Brown tumor • 3. Loss of bone density • 4. Soft tissue calcifications

48. Oral manifestations of patients with hypoparathyroidism 1. Dental abnormalities: -enamel hypoplasia in horizontal lines; -poorly calcified dentin; -widened pulp chambers; -dental pulp calcifications; -shortened roots; -hypodontia; -delay or cessation of dental development. 2. Mandibular tori 3. Chronic candidiasis 4. Paresthesia of the tongue or lips 5. Alteration in facial muscles

49. Addison's disease Availability small (one to several square millimeters) grey-black spots or stripes, dark brown or grey-blue color without signs of inflammation on the mucous membrane of the: • mouth in the cheek area, • tongue edges, • palate, • gums. The spots can be oval or take the form of strips or fine grit, above the level of the mucous membrane, they are not separated.

50. Addison's disease The most common symptoms are fatigue, lightheadedness upon standing or while upright, muscle weakness, fever, weight loss, difficulty in standing up, anxiety, nausea, vomiting, diarrhea, headache, sweating, changes in mood and personality, joint and muscle pains.