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Aggressive and acute periodontal diseases.
[papillon-lefèvre syndrome]
Inflammatory
periodontal
diseases
are
highly
prevalent
,
although
most
of
these
diseases
develop
and
progress
slowly
,
often
unnoticed
by
the
affected
individual
.
However
,
a
subgroup
of
these
diseases
include
aggressive
and
acute
forms
that
have
a
relatively
low
prevalence
but
show
a
rapid-course
,
high
rate
of
progression
leading
to
severe
destruction
of
the
periodontal
tissues
,
or
cause
systemic
symptoms
that
often
require
urgent
attention
from
healthcare
providers
.
Aggressive
periodontitis
is
an
early
-onset
,
destructive
disease
that
shows
a
high
rate
of
periodontal
progression
and
distinctive
clinical
features
.
A
contemporary
case
definition
of
this
disease
is
presented
.
Population
studies
show
that
the
disease
is
more
prevalent
in
certain
geographic
regions
and
ethnic
groups
.
Aggressive
periodontitis
is
an
infectious
disease
,
and
recent
data
show
that
in
affected
subjects
the
subgingival
microbiota
is
composed
of
a
mixed
microbial
infection
,
with
a
wide
heterogeneity
in
the
types
and
proportions
of
microorganisms
recovered
.
Furthermore
,
there
are
significant
differences
in
the
microbiota
of
the
disease
among
different
geographic
regions
and
ethnicities
.
There
is
also
evidence
that
the
Aggregatibacter
actinomycetemycomitans-
JP
2
clone
may
play
an
important
role
in
the
development
of
the
disease
in
certain
populations
.
The
host
response
plays
an
important
role
in
the
susceptibility
to
aggressive
periodontitis
,
where
the
immune
response
may
be
complex
and
involve
multiple
mechanisms
.
Also
,
genetic
factors
seem
to
play
an
important
role
in
the
pathogenesis
of
this
disease
,
but
the
mechanisms
of
increased
susceptibility
are
complex
and
not
yet
fully
understood
.
The
available
data
suggest
that
aggressive
periodontitis
is
caused
by
mutations
either
in
a
few
major
genes
or
in
multiple
small
-effect
genes
,
and
there
is
also
evidence
of
gene
-
gene
and
gene
-environment
interaction
effects
.
Diagnostic
methods
for
this
disease
,
based
on
a
specific
microbiologic
,
immunologic
or
genetic
profile
,
currently
do
not
exist
.
Genetic
markers
have
the
potential
to
be
implemented
as
screening
tools
to
identify
subjects
at
risk
.
This
approach
may
significantly
enhance
treatment
outcome
through
the
early
detection
and
treatment
of
affected
subjects
,
as
well
as
using
future
approaches
based
on
gene
therapy
.
At
present
,
the
treatment
of
this
disease
is
directed
toward
elimination
of
the
subgingival
bacterial
load
and
other
local
risk
factors
.
Adjunctive
use
of
appropriate
systemic
antibiotics
is
recommended
and
may
contribute
to
a
longer
suppression
of
the
microbial
infection
.
Other
aggressive
forms
of
periodontal
diseases
occur
in
patients
who
are
affected
with
certain
systemic
diseases
,
including
the
leukocyte
adhesion
deficiency
syndrome
,
Papillon-
Lefèvre
syndrome
,
Chediak-
Higashi
syndrome
and
Down
syndrome
.
Management
of
the
periodontal
component
of
these
diseases
is
very
challenging
.
Acute
gingival
and
periodontal
lesions
include
a
group
of
disorders
that
range
from
nondestructive
to
destructive
forms
,
and
these
lesions
are
usually
associated
with
pain
and
are
a
common
reason
for
emergency
dental
consultations
.
Some
of
these
lesions
may
cause
a
rapid
and
severe
destruction
of
the
periodontal
tissues
and
loss
of
teeth
.
Oral
infections
,
particularly
acute
infections
,
can
spread
to
extra
-
oral
sites
and
cause
serious
medical
complications
,
and
even
death
.
Hence
,
prompt
diagnosis
and
treatment
are
paramount
.
Diseases
Validation
Diseases presenting
"pain"
symptom
achondroplasia
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
aniridia
aromatase deficiency
carcinoma of the gallbladder
cholangiocarcinoma
coats disease
congenital diaphragmatic hernia
congenital toxoplasmosis
cushing syndrome
cutaneous mastocytosis
cystinuria
dedifferentiated liposarcoma
dentin dysplasia
dracunculiasis
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erdheim-chester disease
erythropoietic protoporphyria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
focal myositis
hirschsprung disease
hodgkin lymphoma, classical
holt-oram syndrome
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
lamellar ichthyosis
liposarcoma
locked-in syndrome
lymphangioleiomyomatosis
malignant atrophic papulosis
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
papillon-lefèvre syndrome
phenylketonuria
pleomorphic liposarcoma
primary hyperoxaluria type 1
proteus syndrome
pyomyositis
scrub typhus
sneddon syndrome
systemic capillary leak syndrome
thoracic outlet syndrome
trochlear dysplasia
typhoid
von hippel-lindau disease
waldenström macroglobulinemia
well-differentiated liposarcoma
wolf-hirschhorn syndrome
This symptom has already been validated