PMC7136767_01
Intraoral examination of a 26-year-old male patient with PLG deficiency (Type 1) showing membranous gingival enlargement.
CRID2020-5680535.001.jpg
PMC7136767_01_CRID2020-5680535.001.jpg
fig1
The periodontal evaluation revealed signs of generalized severe periodontitis, ulceration, and white-yellow fibrinous pseudomembranes (Figure 1).
Panoramic radiograph showing extensive generalized periodontal breakdown.
CRID2020-5680535.002.jpg
PMC7136767_01_CRID2020-5680535.002.jpg
fig2
The panoramic radiograph showed generalized alveolar bone loss of more than 50%, especially in the posterior teeth (Figure 2).
Ligneous conjunctivitis.
CRID2020-5680535.003.jpg
PMC7136767_01_CRID2020-5680535.003.jpg
fig3
Recurrent conjunctivitis was seen as a white membrane in the mucosa of the upper and lower eye lids (Figure 3).
(a) H&E stain; original magnification is x4, while magnification in (b) is x10 and magnification in (c) is x40. Photomicrograph showing parakeratinised stratified squamous surface epithelium with branching and anastomosing rete ridges and connective tissue showing subepithelial deposits of homogenous eosinophilic material that resembled amyloid. The deeper parts show a diffuse mixed inflammatory cell infiltrate comprising predominantly of neutrophils.
CRID2020-5680535.004.jpg
PMC7136767_01_CRID2020-5680535.004.jpg
fig4
Masson's trichrome was negative and PAS variably positive (Figure 4).
Sequence chromatogram and alignment to the reference sequence showing the variation in exon 7of the PLG gene (chr6:161137712G>A; c.704G>A; p.Arg235His) detected in homozygous condition in the patient.
CRID2020-5680535.005.jpg
PMC7136767_01_CRID2020-5680535.005.jpg
fig5
It was analyzed using Picard and GATK version 3.6 to identify variants relevant to the clinical condition (Figure 5).
(a) Surgical excision by internal bevel gingivectomy on the right maxillary region. (b) 3-Month follow-up shows recurrence of the lesion. (c) Excision by diode laser on left maxillary region. (d) 3-Month follow-up shows recurrence of the lesion.
CRID2020-5680535.006.jpg
PMC7136767_01_CRID2020-5680535.006.jpg
fig6
However, recurrence of the lesion was seen after 3 months (Figure 6).