Piknodizostozis Sendromlu Bir Türk Ailenin Klinik Rehabilitasyonu ve Katepsin K Geni Analizi
Psikositozis (PKND), kısa boy, şiddetli kemik kırılganlığı,ekzoftalmi ve mikrognati gibi oral belirtilerle karakterize, nadirgörülen, otozomal resesif bir hastalıktır. Genellikle hipoplastikorta yüz, ön çapraz kapanış, derin damak ve dental çapraşıklık gibitipik kraniyofasiyal deformiteler ile görülür. Bu olgu sunumununamacı, PKND’li üç kardeşin dental tedavilerini sunmak vebildirilen vakalar altında pycnodysostosis için Katepsin K’yıanaliz etmektir. Kliniğimize başvuran ailenin 5 çocuğundanüçünde piknodizostosis görülürken, diğer iki kardeş sağlıklıydı.Çocukların detaylı klinik ve radyolojik muayeneleri yapıldıktansonra etkilenen bireylerin gerekli restoratif ve koruyucu tedavileritamamlandı. Altta yatan nedeni açığa çıkarmak amacıyla, KatepsinK amplifiye edildi ve spesifik primerler kullanılarak doğrudansekanslandı. Etkilenen tüm kardeşler homozigot bir durumolarak L7P varyasyonu taşırken, sağlıklı kardeşlerde ise aynıdurumun heterozigot hali gözlendi. Piknodizostozis sendromluhastalarda kemik kırıklarının kolay oluşması ve tedaviler içinerişimi zorlaştıran sınırlı ağız açıklıkları nedeniyle erken tanı vemüdahale oldukça önemlidir. PKND hastaları için sık kontrollerplanlanmalıdır. Düzenli ağız bakımı ve koruyucu tedavilerinerken dönemde yapılması hastalara daha iyi bir yaşam kalitesisağlamaktadır. Katepsin K’nın L7P varyasyonunun PKND için birtanı kriteri olabileceğini düşünmekteyiz.
The Clinical Rehabilitation and Cathepsin K Gene Analysis of a Turkish Family With Pycnodysostosis
Pycnodysostosis (PKND) is a rare, autosomal recessive diseasecharacterized by short stature, severe bone fragility exophthalmusand oral manifestations such as micrognathia. It usuallydemonstrates typical craniofacial deformities, such as hypoplasticmidface, anterior cross-bite, grooved palate and dental crowding.The aim of this case report is to report the rehabilitation andanalyze the cathepsin K for pycnodysostosis under reported casesof three siblings with PKND. A family with 5 siblings, 3 effectedand 2 non – effected, were examined clinically and radiologically,and restorative treatments and protective applications were carriedout in the effected members. To clarify the underlying reason,cathepsin K was amplified and sequenced directly by usingspecific primers. All the affected members carried L7P variation ashomozygous state, whereas unaffected had the heterozygous stateof the same condition. Early diagnosis and treatment is importantwith PKND patients, since bone fractures easily occur duringdental treatment and limited mouth opening makes it difficult toaccess the treated area. Frequent recalls should be planned forPKND patients. Regular oral care and early preventive treatmentsensure the patients a better life quality. Also, we suggest that L7Pvariation of cathepsin K may be a diagnostic criterion for PKND.
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