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123: Oral Mucosal Lesions In Association With Goodpasture´s Syndrome
EP36129
Poster Title: 123: Oral Mucosal Lesions In Association With Goodpasture´s Syndrome
Submitted on 15 Apr 2021
Author(s): Marketa Janovska, Stepan Podzimek, Zdenek Hruby
Affiliations: Institute of Dental Medicine, General University Hospital in Prague and First Faculty of Medicine, Charles University, Prague,Czech Republic; 2: Institute for Clinical and Experimental Medicine, Prague, Czech Republic
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 335
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Poster Information
Abstract: This case report presents aphthous-like ulcers and dysgeusia in a patient with Goodpasture´s syndrome.

Case summary

A sixty-one-year old patient with Goodpasture´s syndrome was referred for evaluation of oral tissue defects. The patient was hospitalised for acute renal failure, anuria and uremic syndrome as a result of antibodies-induced total renal glomeruli damage. Pulmonary involvement was presented as TRALI (transfusion-related acute lung injury) following a blood transfusion. Hemolytic anemia and thrombocytic microangiopathy were present. Immunosuppressive regimen constituted of systemic corticosteroids, cyclophosphamide and eculizumab biologic agent. During homeostasis deterioration, the patient exhibited painful aphthous lesions on the tongue and buccal mucosa. She also complained of taste disturbance. We treated her locally with dexpanthenol paste and polyhexanide-betaine antiseptic rinse with a satisfying clinical outcome. Dysgeusia is thought to be a consequence of uremia. Both the patient and nephrologist were advised to expect an improvement in taste sensation after stabilisation of the renal parameters.

Conclusions

Aphthous-like ulcers were suggested to be associated with the overall deterioration of homeostasis. Eculizumab biologic agent could also contribute to the development of lesions. Dysgeusia may be common in patients with uremia. Kidney transplantation is a treatment option for end-stage renal disease in patients with Goodpasture´s syndrome. Physicians in transplant centres should be educated about possible oral mucosal manifestations of Goodpasture´s syndrome as these oral lesions may also be indicators of disease deterioration.
Summary: Goodpasture´s syndrome is a rare autoimmune disease characterised by the presence of autoantibodies targeting the membranes of renal glomeruli. Renal and pulmonal failure in Goodpasture´s (pulmonary-renal) syndrome may have fatal consequences. Immunosuppression, plasmapheresis and kidney transplantation constitute the most common treatment options. Oral mucosal manifestations in patients with Goodpasture´s syndrome may be related to multiorgan failure. References:
Acknowledgment: This study was supported by project PROGRES Q29/1LF (First Faculty of Medicine, Charles University, Czech Republic).
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