Cyclic severe decrease in the number of circulating neutrophilic leukocytes

Cycles usually occur in intervals of 21 to 27 days

In some patients the interval may be extended to several months

Episodes of neutropenia generally persist for 2 to 3 days.

Clinical

severe recession can lead to severe perio

ulcerations

tooth mobility

bleeding

gingivostomatitis

lymphoblastic or non lymphoblastic

affects children and young adults

immature lymphocytes

prognosis good

granulocytic myeloid or lymphocytic

immature granulocytes

affects young adults age 15-39

prognosis not so good

Malignant neoplasms of the hemopoietic stem cells

originate in bone marrow

excessive abnormal white blood cells

spleomegaly (large spleen)

weakness, fever

enlarged lymph nodes

bleeding

hepatomegaly (large liver)

chromosomal abnormality( Philadelphia chromosome)

bleeding

petechia

ecchymosis

gingival enlargement

ANUG due to non funtioning WBCs

Elevated wbc with many immature cells, anemia, and a low platelet count

most common

accounts for 25% of all cases

assymptomatic

Half of patients have an abnormal karyotype but is different from Philadelphia chromosome

fatigue

weakness

weight loss

anorexia

Pallor of the lips and gingiva

Gingival enlargement

Petechiae and ecchymosis



Gingival bleeding

Atypical periodontal disease

Cervical lymphadenopathy (may be an early manifestation)

1)integrity of blood vessels walls

2)adequate functioning platelets

3)adequate functioning factors

normal is 150,000-400,000

less than 100,000 is considered thrombocytopenia (low platelet)

spontaneous bleeding occurs at 20,000

Normal prothrombin time (how fast a clot is made)

normal is 11-16 seconds

INR is more common

values under 3 are normal

pts on anticoagulants may be 4 or 5

normal 25-40

prolonged is 45-50

monitored heparin is used for patients in dialysis

over 50 is cause for alarm

I. Fibrinogen

II. Prothrombin

III.Tissue Factor

IV. Calcium

V. Proaccelerin

VI._________

VII. Proconvertin

VIII.Antihemophiliac factor

IX. Plasma thromboplastin

X. Stuart factor

XI. Plasma thromboplastin antecedant

XII. Hageman factor

XIII.Fibrin-stabilizing factor

collagen

xII

XI

IX

X

prothrombin-thrombin

fibrinogen-fibrin

tissue thromboplastin

vii

x

thrombin-fibrin

Oozing of blood from gingival margins without the presence of gingivitis or inflammation

 and purplish spots

Von Willebrand’s disease

Autosomal dominant inherited disorder of platelet function

Most common inherited bleeding disorder

Affects men and women

type A

x linked recessive

males and homozygous females

deficiency infactor VIII (8)

christmas disease

hemophelia type B

defieciency in factor IX (9)

Bruton’s disease (X-linked congenital agammaglobulinemia)

B cells do not mature

•Plasma cells are deficient

•Normal T cells

•Autoimmune diseases are common in these patients

DiGeorge’s syndrome (Thymic hypoplasia)

Thymus is deficient or lacking therefore T lymphocytes do not mature.

•Infants and children with this syndrome are susceptible to fungal, viral and bacterial infections that require T and B cell cooperation

•B lymphocytes and immunoglobulins are unaffected

Severe combined immunodeficiency

Most infants with this type of immunodeficiency die in the first year of life

•Susceptible to all forms of viral, fungal and bacterial infections