The clinical importance of determining cortisol, potassium and IgE-antibodies in patients with intolerance to dental materials
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus
Vestnik VGMU. 2017;16(3):82-90.
Objectives. To determine the levels of cortisol and potassium in the oral fluid (OF) of patients with intolerance to dental materials (IDM).
Material and methods. A survey of 36 patients who complained of IDM was carried out. IgE-antibodies to metals in the blood, the levels of cortisol and potassium in the OF were determined in them. Using the Psychological Stress Scale PSM-25, the integral index of mental tension (IMT) was studied, and by means of the “TD” technique (anxiety and depression) an assessment of the state of anxiety and depression in patients was performed. The evaluation of clinical symptoms of IDM was made on physical examination.
Results. It was established that in all patients with IDM the level of cortisol and potassium in the OF was increased. In patients with objective clinical symptoms of IDM (n=18) and the presence of IgE-antibodies to metals in the blood in 1 month after the removal of orthopedic constructions, there was a decrease in the level of cortisol (before the removal – 6,52±3,21 ng / ml, after the removal – 3,61±2,53 ng / ml) and potassium (before the removal – 88,52 [72,8, 95,3] mg / dl, after the removal – 52,4 [40,1, 66,3] mg / dl) in the OF (p<0,05), which made it possible to distinguish the allergic type of IDM.
It was found that in patients with IDM complaints, but without objective clinical symptoms (n=18) in 1 month after the removal of orthopedic constructions the initially elevated cortisol and potassium levels did not decrease (p<0,05), and their levels strongly correlated with the index of mental stress (the level of stress) (cortisol – RSpearman=0,88; p<0,05; potassium – RSpearman=0,79; p<0,05), which allows us to identify the psychosomatic type of IDM.
Conclusions. The study of the level of cortisol and potassium in the OF is a convenient and informative method for diagnosing allergies and endogenous hypercorticoidism in patients with IDM.
Key words: hypersensitivity, stress, IgE-antibodies, cortisol, potassium, oral fluid, dental materials.
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Information about authors:
Karpuk I.Y. – Candidate of Medical Sciences, associate professor, doctoral candidate of the Сhair of Clinical Immunology &Allergology with the course of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.