Zastosowanie terapii fotodynamicznej w leczeniu zapalenia przyzębia u pacjenta z neutropenią wrodzoną (zespołem Kostmanna) – opis przypadku

The use of photodynamic therapy in the treatment of periodontitis in a patient with congenital neutropenia (Kostmann syndrome) – a case report

The term neutropenia is used to refer to a group of white blood cell diseases in which the number of neutrophils in the bloodstream drops below 1500/mm³ (normal range 1.8–7.7 x 10³/µl).

This haemopathy is ranked among the most common immunodeficiency diseases, although particular disease entities differ in terms of their etiopathogenesis and clinical course. Neutropenia usually occurs as an acquired, secondary immune deficiency caused by the use of certain medication, undernourishment, or another systemic disease. Primary, congenital neutropenias are less common. This type of neutropenia is usually accompanied by genetic syndromes (e.g.: Down’s syndrome, insulin-dependent diabetes, Crohn’s disease, Shwachman syndrome, Papillon-Lefevre syndrome, agammaglobulinemia, or dysgammaglobulinemia), but may also occur as an isolated disease, such as congenital neutropenia, cyclic neutropenia, or severe infantile agranulocytosis (known as Kostmann syndrome) (1-3).

The major role of neutrophils, which act as the first line of non-specific response, is to destroy micro-organisms through phagocytosis. Therefore, the defects in neutrophil maturation and function make the body more susceptible to infections (1, 2, 4). The most common pathogens in neutropenic patients are: staphylococcus aureus, Gram-negative bacteria, Candida and Aspergillus fungal species, and Herpes viruses (1, 2). The patients often struggle with upper and lower respiratory tract infections, urinary tract infections, otitis media, boils, purulent skin infections and st...