Pathophysiology
In healthy individuals, the human heart develops around the 20th day of gestation, when the outer endocardial tubes merge into a single cardiac tube. Thereafter, the cardiac tube begins to fold, developing into the atrium and ventricle. The right ventricle is dominant prior to birth, receiving 65% of the venous return to the heart, and is the main contributor of blood flow to the lower part of the body, the placenta, and the lungs. Though the exact cause of TOF is unknown, an association that has been observed is an anterior deviation of the infundibular septum that results in a misaligned VSD, with an overriding aorta causing a subsequent right ventricular obstruction.Different factors such as pulmonary stenosis can also contribute with the right ventricular outflow obstruction. During tet spells, a decrease in systemic vascular resistance or an increase in pulmonary resistance would be physiologically observed. The main anatomic defect in TOF is the anterior deviation of the pulmonary outflow septum. This defect results in narrowing of the right ventricular outflow tract (RVOT), override of the aorta, and a VSD. Four malformations
"Tetralogy" denotes four parts, here implying the syndromes four anatomic defects. This is not to be confused with the similarly named teratology, a field of medicine concerned with abnormal development and congenital malformations (including tetralogy of Fallot). Below are the four heart malformations that present together in tetralogy of Fallot:

There is anatomic variation between the hearts of individuals with tetralogy of Fallot.
The diagnosis is made by  microscopic examination of biopsy tissue: direct immunofluorescence can reveal the presence of antinuclear antibodies specifically directed against the ΔNp63α form of the p63 protein, which is normally expressed within the basal layer of stratified epithelium. Treatment with hydroxychloroquine can be effective. Plasma cell gingivostomatitis
Terms such as plasma cell gingivostomatitis, atypical gingivostomatitis and idiopathic gingivostomatitis are sometimes a synonym for plasma cell gingivitis, or specifically to refer to a severe form of plasma cell gingivitis. Other forms of stomatitis
Periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA) syndrome—occurs in children. Uremic stomatitis—a rare form of stomatitis that occurs with kidney failure. Pyostomatitis vegetans
Bovine papular stomatitis

References


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