Maria Elisa Rangel Janini

Shedding of Polyomavirus in the Saliva of Immunocompetent Individuals

The aim of this study was to investigate and compare the frequency of BKV, JCV, WUV, and KIV in the saliva of healthy individuals. Samples were analyzed for the presence of polyomaviruses (BKV, JCV, WUV, and KIV) DNA by real‐time PCR. Of the 291 samples tested, 71 (24.3%) were positive for at least one of the screened polyomaviruses. Specifically, 12.7% (37/291) were positive for WUV, 7.2% (21/291) positive for BKV, 2.4% (7/291) positive for KIV, and 0.3% (1/291) positive for JCV. BKV and WUV co‐infections were detected in 1.7% (5/291) of individuals. No other co‐infection combinations were found. The mean number of DNA copies was high, particularly for WUV and BKV, indicating active replication of these viruses. Polyomavirus detection was higher among individuals 15–19 years of age (46.0%; 23/50) and ≥50 years of age (33.3%; 9/27). However, the detection rate in the first group was almost 1.7× greater than the latter. WUV infections were more frequent in individuals between the ages of 15 and 19 years and the incidence decreased with age. By contrast, BKV excretion peaked and persisted during the third decade of life and KIV infections were detected more commonly in subjects ≥50 years old. These findings reinforced the previous hypotheses that saliva may be a route for BKV transmission, and that the oral cavity could be a site of virus replication. These data also demonstrated that JCV, WUV, and KIV may be transmitted in a similar fashion. J. Med. Virol. 85:144–148, 2012.

Diagnosis and treatment of persistent oral lesions caused by herpesvirus in a patient with pemphigus vulgaris

The Greek word pemphigus means a bubble or a blister. Pemphigus consists of a group of epidermal diseases associated with bullae and acantholysis. Pemphigus results from circulating immunoglobulin G (IgG) antibodies directed against desmosomes; these antibodies interfere with keratinocyte adhesion leading to acantholysis resulting in the formation of bullae. There are six main types of pemphigus, and their classification is based on the anatomic features of the lesion and the target antigens recognized by the autoantibodies: pemphigus vulgaris, pemphigus vegetans, pemphigus erythematosus, pemphigus foliaceus, paraneoplastic pemphigus, and IgA pemphigus. Pemphigus vulgaris (PV) is the most common variant showing oral lesions as an initial manifestation in 50% of cases. Pemphigus vulgaris is characterized by a suprabasal split and autoantibodies IgG against desmoglein 3 only (mucosal dominant type) or both against desmoglein 1 and 3 (mucocutaneous type). Desmoglein 1 and desmoglein 3 are normal components of keratinocyte cell membrane, with molecular weights of 160 and 130 kDa, respectively. Circulating and tissue-bound autoantibodies of both the IgG1 and IgG4 subclasses may be demonstrated. The role of heterogeneous environmental factors often seems decisive in triggering and activating the disease in genetically predisposed subjects. In many cases, pemphigus seems to occur when environmental factors combine with genetic ones. The exogenous factors include: drugs, physical agents such as burns, ultraviolet radiation, x-rays, viruses, neoplasms, hormones and pregnancy, nutritional factors, and emotional stress. Various reports have pointed to the possible part played by viral infections, in particular herpesvirus infections. Schlüpen et al. detected herpes simplex virus (HSV) specific DNA 335

Laboratory diagnosis of herpesvirus infections in patients with Pemphigus vulgaris lesions.

Background/Aims: Pemphigus vulgaris (PV) is an autoimmune disorder that has an etiology impacted by genetic and exogenous factors. Viral infections, in particular herpesvirus infections, have been identified as possible PV triggers which in addition cause serious complications in these patients. This study investigates the frequency of herpesvirus infections in patients with PV lesions. Methods: Polymerase chain reaction and DNA sequence analyses were used to determine the presence of herpes simplex virus (HSV)-1/2, varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), and human herpesvirus types 6, 7, and 8 (HHV-6, HHV-7, and HHV-8) DNA in 105 mucosal and/or skin swabs harvested from 23 patients presenting with PV lesions. Results: Thirty-six samples collected from 17 patients were positive for at least 1 virus; 3 were positive for HSV-1, 2 for HSV-2, 2 for CMV, and 7 each for HHV-6 and HHV-7. Coinfections were observed in 15 samples. Infections with VZV, EBV, HHV-6A, and HHV-8 were not detected. Herpesvirus infections were detected in 21% (13/62) of reactivated lesions, 54.5% (18/33) in persistent lesions, 40% (2/5) in exacerbated lesions, and 60% (3/5) in lesions in remission. Conclusion: PV lesions which do not show improvement following administration of adequate immunosuppressive therapy should be screened for the presence of herpesvirus infections.

Doença de paget com manifestação nos maxilares

An unusual case of Pagets disease of bone, presenting as a maxillary disease, is discussed. This rare manifestation of a systemic disease led to an initial difficulty in establishing the diagnosis; indeed, the etiology was only determined after the lesion biopsy. Bisphosphonates were used with a good response. We highlight in this article the need for a multidiscipli-nary follow-up of such patients due to odonthological complications of the disease when localized in the jaw.

Clinical and oral findings in an Afro-Brazilian family with Gorlin-Goltz syndrome: case series and literature review

Gorlin-Goltz syndrome (GGS) seems to be unusual in black persons. The authors present an Afro-Brazilian family case report of GGS. The main complaint of the index case was a painless swelling of the left mandible, which was diagnosed as an odontogenic keratocyst. Further classical features of the Syndrome were present in this patient. Other two family members were diagnosed as cases of GGS and one of them presented 11 clinical findings characteristic of the syndrome. From the three cases reported, two of them presented five major diagnostic criteria for the GGS, and the diagnosis was only made because of an oral complaint. This case series emphasizes the importance of carefully examining the patient and close relatives for signs of GGS, even if they belong to an ethnic group in which this diagnosis is unusual.

Changes in the vibration sensitivity and pressure pain thresholds in patients with burning mouth syndrome

Objective To investigate the presence of changes in vibration detection and pressure pain threshold in patients with burning-mouth syndrome (BMS). Design of the study Case-control study. The sample was composed of 30 volunteers, 15 with BMS and 15 in the control group. The pressure-pain threshold (PPT) and vibration-detection threshold (VDT) were examined. The clinical evaluation was complemented with the McGill Pain Questionnaire (MPQ), Douleur Neuropathique 4 (DN4) and Beck Depression and Anxiety Inventories (BDI and BAI, respectively). Results BMS subjects showed a statistically significant higher PPT in the tongue (p = 0.002), right (p = 0.001) and left (p = 0.004) face, and a significant reduction of the VDT in the tongue (p = 0.013) and right face (p = 0.030). Significant differences were also found when comparing the PPT and the VDT of distinct anatomical areas. However, a significant interaction (group × location) was only for the PPT. BMS subjects also showed significantly higher levels of depression (p = 0.01), as measured by the BDI, compared to controls; and a significant inverse correlation between the VDT in the left face and anxiety levels was detected. Conclusions The study of somatosensory changes in BMS and its correlations with the clinical features as well as the levels of anxiety and depression expands current understanding of the neuropathic origin and the possible contribution of psychogenic factors related to this disease.