Pediatric dentistry approach in a child with Aicardi-Goutières Syndrome type 2: A case report and literature review

Melis Arda Sözüöz¹ image, Ezgi Aydın Varol2 image, Merve Aksoy3 image

Highlights

Aicardi-Goutières Syndrome is a rare congenital disorder with limited documentation on dental management strategies for pediatric patients.

This case report is the first to document delayed primary teeth eruption in Aicardi-Goutières Syndrome Type 2.

Pediatric dentists should monitor patients with Aicardi-Goutières Syndrome for early caries and guide parents on oral hygiene to support healthy dental development.

Abstract

Aicardi-Goutières Syndrome is a rare autosomal recessive disorder characterized by a triad of partial or complete agenesis of the corpus callosum, infantile spasms, and chorioretinal lacunae. The condition predominantly affects females, as males often do not survive the embryonic period. Intellectual disability associated with the syndrome ranges from mild to moderate. There is limited information in the literature regarding the oral manifestations of this syndrome. This case report aims to provide insights into the development of primary dentition in patients with Aicardi-Goutières Syndrome and to raise awareness about the oral and dental health needs of these rare pediatric patients, particularly during early childhood. In this case report, it was observed that the primary teeth of a 2-year-5-month-old patient had not yet erupted. Notably, even at 3 years and 1 month old, the patient’s primary dentition remained incomplete despite continued monitoring during follow-up examinations. These patients often have limited ability to cooperate with dental treatments due to their intellectual disability, which complicates the process. Furthermore, due to the respiratory risks associated with the syndrome, dental treatments under general anesthesia are generally not preferred. In this context, maintaining the oral health of these patients and implementing preventive strategies, including topical fluoridation, along with appropriate oral hygiene instructions and dietary modifications, are crucial in managing patients with Aicardi-Goutières Syndrome. Pediatric dentists are responsible for educating families on these matters, and caregivers play a vital role in maintaining the oral health of these patients by collaborating closely with dental specialists.

Keywords: Aicardi Syndrome; Preventive Dentistry; Tooth Eruption

Author Affiliations

  1. DDS PhD, Health Sciences University, Gulhane Faculty of Dentistry, Department of Pediatric Dentistry, Ankara, Türkiye (Correspondence:melisarda7@gmail.com)
  2. DDS PhD, Health Sciences University, Gulhane Faculty of Dentistry, Department of Pediatric Dentistry, Ankara, Türkiye
  3. Assoc. Prof. Dr, Health Sciences University, Gulhane Faculty of Dentistry, Department of Pediatric Dentistry, Ankara, Türkiye
  1. Aicardi J. Aicardi syndrome: Old and new findings. Int Pediatr 1999;14:5-8
  2. Aicardi J. Aicardi syndrome. Brain Dev 2005;27:164-171
  3. Fischbach M. Rare genetic diseases – New opportunities and challenges through biotechnological progress and scientific knowledge. Eur J Paediatr Neurol 2002;6(Suppl A):71-75
  4. Guadagni MG, Faggella A, Piana G. Aicardi syndrome : a case report. Eur J Paediatr Dent 2010:146-148
  5. Aicardi J, Lefebvre J, Lerique-Koechlin A. A new syndrome: spasm in flexion, callosal agenesis, ocular abnormalities. Electroencephalogr Clin Neurophysiol 1965;19: 609-610
  6. Prats Viñas JM, Martinez Gonzalez MJ, Garcia Ribes A, Martinez Gonzalez S, Martinez Fernandez R. Callosal agenesis, chorioretinal lacunae, absence of infantile spasms, and normal development: Aicardi syndrome without epilepsy? Dev Med Child Neurol 2005;47:419-420
  7. Pathak PD, Shah PP, Lkade LS, Shinde MU. Full Mouth Rehabilitation of a Child with Aicardia-Goutières: A Rare Syndrome. J Clin Diagn Res 2023;17: 19-21
  8. Crow YJ, Manel N. Aicardi-Goutières syndrome and the type I interferonopathies. Nat Rev Immunol 2015;15:429-440
  9. Al Mutairi F, Alfadhel M, Nashabat M, El-Hattab AW, Ben-Omran T, Hertecant J et al. Phenotypic and Molecular Spectrum of Aicardi-Goutières Syndrome: A Study of 24 Patients. Pediatr Neurol 2018;78:35-40
  10. Takeichi T, Katayama C, Tanaka T, Okuno Y, Murakami N, Kono M et al. A novel IFIH1 mutation in the pincer domain underlies the clinical features of both Aicardi-Goutières and Singleton-Merten syndromes in a single patient. Br J Dermatol 2018;178:111-113
  11. Livingston JH, Crow YJ. Neurologic Phenotypes Associated with Mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR1, and IFIH1: Aicardi-Goutières Syndrome and Beyond. Neuropediatrics 2016;47:355-360
  12. Florido-Rodriguez A, Eiris-Punal J, Barros-Angueira F, Toledo-Bravo de Laguna L, Santana-Artiles A, Sebastian-Garcia I et al. Sindrome de Aicardi-Goutieres por mutacion en el gen IFIH1 con afectacion pontina. A proposito de un caso [Aicardi-Goutieres syndrome due to mutation of the IFIH1 gene with pontine involvement. A case report]. Rev Neurol 2016;63:309-314
  13. ISO 3950:2016 Dentistry: Designation system for teeth and areas of the oral cavity. [Internet] 2020 [cited 2024 Aug 1]. Available from: https://www.fdiworldental.org/
  14. Piccoli C, Bronner N, Gavazzi F, Dubbs H, De Simone M, De Giorgis V et al. Late-Onset Aicardi-Goutières Syndrome: A Characterization of Presenting Clinical Features. Pediatr Neurol 2021;115:1-6
  15. Viguera-Elías D, de la Iglesia-Nagore I, Toledo-Gotor C, Domínguez-Garrido E, Poch-Olivé ML. Síndrome de Aicardi-Goutières: un caso familiar por alteración del gen RNASEH2B [Aicardi-Goutieres syndrome: a family case due to alteration of the RNASEH2B gene]. Rev Neurol 2021;72:407-409
  16. Rice GI, Forte GM, Szynkiewicz M, Chase DS, Aeby A, Abdel-Hamid MS et al. Assessment of interferon-related biomarkers in Aicardi-Goutières syndrome associated with mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, and ADAR: A case-control study. Lancet Neurol 2013;12:1159-1169 
  17. Wu D, Fang L, Huang T, Ying S. Case Report: Aicardi-Goutières Syndrome Caused by Novel TREX1 Variants. Front Pediatr 2021;28;9:634281
  18. Rosser TL, Acosta MT, Packer RJ. Aicardi syndrome: spectrum of disease and long- term prognosis in 77 females. Pediatr Neurol 2002;27:343–346
  19. Grosso S, Lasorellab G, Russo A, Galluzzi P, Morgese G, Balestri P. Aicardi syndrome with favorable outcome: case report and review. Brain Dev 2007;29:443-446
  20. Lacobucci T, Galeone M, de Francisci G. Anaesthesia management in a patient with Aicardi’s Syndrome. Anaesthesia 2003;58:95-95
  21. Iwamoto T, Fukumoto S, Yamada A. Presurgical treatment of cleft lip and palate in Aicardi syndrome : A case report. Pediatr Dent J 2008;18:204-209
  22. Baykan Z, Sahin F, Beyazova U, Ozçakar B, Baykan A. Experience of Turkish parents about their infants’teething. Child Care Health Dev 2004;30:331-336

Article Info

Contemp Pediatr Dent 2024:5(2):105-112

Received: 13 June 2024

Accepted: 18 August 2024

Online First: 21 August 2024

374 views

Full Text

Attachments

Attachments

File Downloads
pdf CPD_2024_20 653

How to Cite

				
					Melis Arda Sözüöz, Ezgi Aydın Varol, Merve Aksoy. Pediatric dentistry approach in a child with Aicardi-Goutières Syndrome type 2: A case report and literature review. Contemp Pediatr Dent 2024:5(2):105-112.
				
			

Related Articles

Share Article

Under a Creative Commons license