Host Defensive, Immunological, and Microbiological Observations of an Early-Onset Periodontitis Patient with Virus-Associated Hemophagocytic Syndrome

Takayuki Kono, Masayuki Takigawa, Fusanori Nishimura, Shogo Takashiba, Masatsugu Nakagawa, Hiroshi Maeda, Hideo Arai, Atsushi Nagai, Hidemi Kurihara, Yoji Murayama

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4 Citations (Scopus)


Virus-associated hemophagocytic syndrome (VAHS) is a disorder characterized by benign generalized histiocytic proliferation and marked hemophagocytosis associated with systemic viral infection. An immunodeficiency which includes an extremely decreased leukocyte and platelet count together with abnormalities in the CD4/CD8 ratio are the most common features of VAHS. Here we report an early-onset periodontitis (EOP) patient with VAHS from the standpoint of host-parasite interaction to understand the effect of this systemic disorder which might possibly influence susceptibility to periodontal disease. The patient is a 16-year-old Japanese male clinically diagnosed as having generalized EOP with slight gingival inflammation and moderate bone loss. This patient manifested VAHS at 3 years of age, and then had an unusual 4 recurrences (at 5, 7, 11, and 14 years old). Laboratory tests conducted include: 1) complete blood analyses; 2) peripheral neutrophil functions (chemotaxis, phagocytosis, superoxide production, and adherence); 3) peripheral lymphocyte subpopulations and functions, T-cell proliferative activity and productivity of cytokines (interleukin-2 [IL-2], interferon gamma [IFN-γ], and tumor necrosis factor alpha [TNF-α]); 4) serum cytokine levels (IL-lß, IL-2, soluble β IL-2 receptor [sIL-2R], IL-4, IL-6, IFN-γ, and TNF-α; 5) serum immunoglobulin G (IgG) antibody titers against periodontopathic bacteria; 6) serological human leukocyte antigen (HLA) typing; and 7) determination of bacterial flora of the periodontal pockets. The results indicated that the patient's neutrophil chemotaxis and random migration were below the normal range. In lymphocyte examinations, T-cell proliferative activity, IL-2, and IFN-γ productivity were elevated. Serum IFN-γ level was also significantly higher than normal range. No specific periodontopathic bacteria were predominant in the periodontal pockets, however, the serum IgG titer against Porphyromonas gingivalis was elevated throughout the examination period. It is suggested that VAHS might be a possible risk factor for periodontal disease, and hence may serve as a model in understanding the role of host defense mechanisms in the establishment of inflammatory periodontal disease.

Original languageEnglish
Pages (from-to)1223-1230
Number of pages8
JournalJournal of periodontology
Issue number12
Publication statusPublished - Dec 1997
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Periodontics


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