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Neutropenia is a transient or chronic blood disorder characterized by a decrease in the number of circulating polymorphonuclear leukocytes (PMNs). Neutrophils are a major cellular defense against infection, and depletion of these cells is potentially fatal. Stomatitis and gingivitis frequently are seen in patients with neutropenia. Therefore, the diagnosis of severe oral pathoses of obscure origin must include a differential white blood cell count. The importance of the dentist's role is dramatically illustrated in the rare case reported here, since the oral condition was the reason for this patient's definitive blood work‐up. The report illustrates the importance of the laboratory assessment in dental patients with unusual periodontal destruction or other inexplicable oral changes.

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Eleven patients with periodontitis, ten patients with juvenile periodontitis and ten control subjects were studied to compare systemic and local immunologic responses and various other blood parameters. A more intensified immunologic response was seen in juvenile periodontitis as compared to periodontitis or controls as evidenced by: (1) greater number of plasma cells and lymphocytes in biopsy specimens of involved gingiva stained by Harris hematoxylin and eosin; (2) significant decrease in serum C4 levels and slightly elevated serum IgG levels as determined by radial immunodiffusion; (3) marked increase of positive fluorescing cells in biopsy specimens stained with antihuman immunoglobulin conjugate and an increase in complement deposition in the same tissues as determined by immunofluorescence. No significant differences among the two groups of patients and control subjects were observed with respect to complete blood counts, coagulation studies, or blood glucose levels. These findings suggest that the immunologic responses in periodontitis and juvenile periodontitis are qualitatively similar, but that the intensity of the response is greater in juvenile periodontitis.

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