A case of localized chronic periodontitis in a patient with IgA nephropathy

Abstract

IgA nephropathy is a form of chronic glomerulonephritis that is reportedly associated with chronic intraoral infection. Here, we report the case of a 50-year-old female with chronic localized periodontitis and IgA nephropathy who underwent treatment for 4 years and is currently undergoing supportive periodontal therapy (SPT). The patient presented with gingival redness, swelling, and occasional pyorrhea. We considered the possibility of her periodontal condition being associated with the IgA nephropathy and planned treatment accordingly. Our treatment plan comprised intensive control of the periodontal tissue inflammation. Teeth nos. 12 and 35 were extracted because of the difficulty in achieving inflammation control in these teeth and the severity of the surrounding tissue destruction. Considering the effects of the treatment for IgA nephropathy, we devised a minimally invasive treatment plan that primarily included initial periodontal therapy. Antibiotic prophylaxis was administered prior to scaling and root planing. Tooth no. 47 was transplanted into the position of tooth no. 46 to improve the masticatory function. Although her periodontal condition worsened after the administration of steroids for the treatment of IgA nephropathy and of female hormones for menopausal disorder, periodic SPT and strict plaque control resulted in significant improvement, and at present, she continues to maintain a good periodontal state. Her renal function is also stable currently, and she is under annual medical follow-up. Continuing periodic SPT and strict plaque control while monitoring the patientʼs general health and renal function is important to prevent aggravation of the periodontitis, which may lead to recurrence of IgA nephropathy. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 55(4)：357-365, 2013.