Early diagnostic of Addison disease at an outpatient stomatology appointment

Abstract

Relevance. Nowadays dentists meet with patients with various morphological changes of the oral mucosa in outpatient medical appointment. In certain cases such morphological mucosal changes are considered as normal condition but sometimes the existence of mucosal changes means the manifestation of somatic diseases. For example, oral mucosa pigmentation might be both a normal case and a first clinical manifestation of chronic adrenal insufficiency. Purpose . To investigate dentists’ diagnostic abilities of early Addison’s disease symptoms. Materials and methods . In 8 patients of subsequent study intraoral mucosal pigmentation was detected. Six patients had no general complaints in their case reports, and according to their words, the pigment spots exist from their adolescence. There were general complaints typical to Addison’s disease in the two remaining clinical cases. General blood test and ACTH (synaptic test) were accomplished to identify Addison’s disease. To determine the level of sodium and potassium content biochemical blood test was also carried out. Results. Chronic adrenal insufficiency was detected by laboratory testing in two patients with general complaints who had no clinical manifestations of Addison’s disease of the skin. Conclusion. In some cases oral mucosa pigmentation may be the first clinical manifestation of chronic adrenal insufficiency. Therefore, the knowledge of somatic symptoms of chronic adrenal insufficiency and indices of laboratory diagnostic for on-time diagnostics of Addison’s disease is highly important and necessary for all dental specialists.