Defective neutrophil function in an insulin-dependent diabetes mellitus patients. A case report.

Christopher W Cutler, P. Eke, R. R. Arnold, T. E. Van Dyke

Research output: Contribution to journalArticle

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Abstract

The objective of this study was to evaluate the polymorphonuclear leukocyte (PMN) function in a poorly controlled adult insulin-dependent diabetic patient (IDDM) with severe recurrent periodontitis, while describing the microbiological and clinical findings. Chemotaxis, superoxide production, and phagocytosis and killing of Porphyromonas (Bacteroides) gingivalis by the IDDM PMN were evaluated 1 week before treatment relative to a healthy, matched control. These analyses revealed a significant (P less than .05) depression in the number of IDDM PMNs migrating along an FMLP gradient (Boyden chamber assay). In addition, a significant (P less than .05) enhancement of IDDM PMN superoxide production in response to opsonized zymosan (cytochrome C reduction) was observed. Phagocytosis and killing (fluorochrome phagocytosis assay) by IDDM PMN of two P. gingivalis strains was also impaired significantly (P less than .05). The subgingival microflora contained significant levels of P. gingivalis, Actinobacillus actinomycetemcomitans, Eikenella corrodens, and Peptostreptococcus micros. Periodontal treatment consisted of extraction of hopeless teeth, scaling and root planing and 3 weeks of Augmentin therapy. The antibiotic therapy resulted in unrecoverable numbers of the putative pathogens and a reduction in both gingival inflammation and disease progression. The IDDM healing response to previous surgical treatment and extractions was poor, presumably due to a marked thrombocytopenia (91 x 10(3) platelets/mm3).

Original languageEnglish (US)
Pages (from-to)394-401
Number of pages8
JournalJournal of Periodontology
Volume62
Issue number6
StatePublished - Jun 1 1991
Externally publishedYes

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Type 1 Diabetes Mellitus
Neutrophils
Phagocytosis
Porphyromonas gingivalis
Superoxides
Eikenella corrodens
Gingival Diseases
Root Planing
Peptostreptococcus
Aggregatibacter actinomycetemcomitans
Tooth Root
Therapeutics
Amoxicillin-Potassium Clavulanate Combination
Zymosan
Periodontitis
Chemotaxis
Cytochromes
Fluorescent Dyes
Thrombocytopenia
Disease Progression

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Defective neutrophil function in an insulin-dependent diabetes mellitus patients. A case report. / Cutler, Christopher W; Eke, P.; Arnold, R. R.; Van Dyke, T. E.

In: Journal of Periodontology, Vol. 62, No. 6, 01.06.1991, p. 394-401.

Research output: Contribution to journalArticle

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