Abstract
Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.
Highlights
Hemophilia is a hemorrhagic disorder caused by hereditary deficiency of factor VIII or IX, characterizing hemophilia A and B, respectively[2,5,14]
Twenty-nine (34%) out of 86 hemophiliacs showed one or more viral infections diagnosed by serological tests (Table 1)
The present results revealed that C. albicans and C. tropicalis were the most common species in controls and hemophiliacs
Summary
Hemophilia is a hemorrhagic disorder caused by hereditary deficiency of factor VIII or IX, characterizing hemophilia A and B, respectively[2,5,14]. Hemophilia A is caused by reduction of the serum level or activity of factor VIII, an important protein in the activation of factor X in the blood clotting sequence. The disease shows an X-linked recessive pattern, affecting predominantly males. According to factor VIII activity detected in blood, hemophilia is classified in mild (6 to 30% of activity), moderate (2 to 5%) and severe (less than 1%). Hemorrhagic episodes are related to the severity of the disease, all patients can suffer hemorrhage following trauma or surgical procedures[2,5,13]. Hemophilia B is characterized by deficiency of factor IX with its pattern of transmission and clinical characteristics similar to hemophilia A13
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