Significance of periodontal health in primary immune thrombocytopenia- a case report and review of literature (original) (raw)
Related papers
Journal of Research in Dentistry
Immune thrombocytopenic purpura (ITP) is a disease associated to the decrease of platelet count in peripheral blood, with repercussion on the oral cavity, due to the potential risk of spontaneous bleeding or provoking it. The aim of this work was evaluate the relation between the platelet count of chronic IPT patients and their periodontal condition. Thereunto, 31 patients were evaluated; 15 with this pathology (group 1) and 16 Dentistry students with no hematologic disease (group 2). Both groups were examined in their periodontal condition through gingival condition index (G), periodontal attachment loss (P) and gingival recession (R), as well as blood tests were performed to verify the platelet count, further a questionnaire on the socioeconomic aspects, access to dentistry services and mouth health self-perception. It was observed that 68.8% of IPT patients’ mouth sextants presented some degree of gingivitis, despite some 16.8% manifested loss of periodontal insertion. Gingival r...
Immune Thrombocytopenic Purpura Presenting as Unprovoked Gingival Hemorrhage: a Case Report
The Open Dentistry Journal, 2014
Immune thrombocytopenic purpura is an autoimmune disease characterized by auto-antibody induced platelet destruction and reduced platelet production, leading to low blood platelet count. In this case report, the clinical diagnose of a patient with immune thrombocytopenic purpura and spontaneous gingival hemorrhage by a dentist is presented. The patient did not have any systemic disease that would cause any spontaneous hemorrhage. The patient was referred to a hematologist urgently and her thrombocyte number was found to be 2000/μL. Other test results were in normal range and immune thrombocytopenic purpura diagnose was verified. Then hematological treatment was performed and patient’s health improved without further problems. Hematologic diseases like immune thrombocytopenic purpura, in some cases may appear firstly in the oral cavity and dentists must be conscious of unexplained gingival hemorrhage. In addition, the dental treatment of immune thrombocytopenic purpura patients must ...
Hemorrhagic plaques in the oral cavity: A clue to diagnosing thrombocytopenia
Our Dermatology Online, 2021
Idiopathic thrombocytopenic purpura is a disorder with a myriad of possible clinical presentations. The mechanism of thrombocytopenia involves both increased platelet destruction and impaired platelet production. The patient can manifest a wide range of symptoms: from asymptomatic or minimal gingival bleeding to profuse bleeding from any site. The disease may first present itself to the dermatologist in cutaneous findings such as petechiae, purpura, and mucosal manifestations in the form of gingival bleeding and hemorrhagic bullae. The diagnosis of idiopathic thrombocytopenic purpura is mostly done by exclusion. In this report, we present two cases with characteristic oral manifestations, who were diagnosed, on investigation, with idiopathic thrombocytopenic purpura. The patients were successfully treated with immunosuppressive therapy. The report aims to raise awareness that would help in enabling prompt referral to the appropriate specialty, especially because of the rarity of thi...
Dentistry Journal, 2021
A 47-year-old Caucasian man, in good general, oral and periodontal health, presented with a non-bleeding bluish lesion on the back of his tongue, presumably due to an ecchymotic area of traumatic origin which was left untreated. The day after, other ecchymotic-type lesions on the mucous membranes of the cheeks and the upper lip, a bleeding lesion at the apex of the tongue and gingivorrhagia, along with petechiae on the back, scalp, lower limbs and feet, occurred, with rapid clinical deterioration, requiring immediate hospitalization. Oral, dermatological, and hematological evaluations lead to idiopathic thrombocytopenic purpura (ITP) diagnosis and hydrocortisone prescription, with a complete recovery in the next few days.The presented case of ITP, with early intra-oral manifestations, aimed both to emphasize the role of oral healthcare workers in theearly recognition of ITP, which may be especially relevant for those cases with extremely fast platelet depletion, high risk of interna...
TH Open, 2021
Background Dentoalveolar procedures in immune thrombocytopenia (ITP) pose a risk of bleeding due to thrombocytopenia and infection due to immunosuppressive treatments. We aimed to systematically review the safety and management of dentoalveolar procedures in ITP patients to create practical recommendations. Methods PubMed, Embase, Cochrane, and Cinahl were searched for original studies on dentoalveolar procedures in primary ITP patients. We recorded bleeding- and infection-related outcomes and therapeutic strategies. Clinically relevant bleeding was defined as needing medical attention. Results Seventeen articles were included, of which 12 case reports/series. Overall, the quality of the available evidence was poor. Outcomes and administered therapies (including hemostatic therapies and prophylactic antibiotics) were not systematically reported. At least 73 dentoalveolar procedures in 49 ITP patients were described. The range of the preoperative platelet count was 2 to 412 × 109/L. ...
Aggressive periodontitis: A clinico-hematological appraisal
Journal of Indian Society of Periodontology, 2014
Background: Human leukocyte antigens (HLA) have been considered a candidate of genetic risk markers for aggressive periodontitis (AP). AP has also been associated with polymorphonuclear leukocyte (PMN) dysfunction. The role of monocyte subsets in AP has also not been completely explored. Therefore, the present study was undertaken to assess in, AP subjects, the possible association between defective PMN adhesion and β 2 -integrin expression; defective neutrophil migration and actin polymerization level; the expression of ABO blood group and HLA antigen; and the percentage of CD14+ CD16+ monocytes and CD45RA monocytes. All these parameters have been compared with the subjects of chronic periodontitis (CP) and healthy controls. Materials and Methods: A total of 45 subjects of the age group 20-50 years, free from any known systemic disease, were divided into three groups -Group I -periodontally healthy control (n = 15), Group II -CP (n = 15) and Group III -AP (n = 15). Peripheral blood samples were collected. ABO grouping and HLA typing were performed. β 2 -integrin expression, actin polymerization level and percentage of CD14+ CD16+ monocytes and CD45RA monocytes were estimated by fluorescence-activated cell sorter analysis. Results: Most of the subjects of AP belonged to the blood group "AB," and an increased frequency of HLA-A30, CW1 and DR1 (P < 0.1) and B44 and DQ2 (P < 0.05) were also observed in this group. In the AP group, both average values (β 2 -integrin and actin level) were significantly less than those of normal subjects (P < 0.001). The mean percentage of CD14+ CD16+ monocytes was found to be maximum in CP, followed by AP, and then in healthy subjects, while the mean percentage of CD45RA was maximum in AP, followed by CP, and then in healthy subjects. Conclusions: With the present state of knowledge from this study, a definite association of ABO blood groups and HLA phenotypes with periodontal diseases is yet to be established. Leukocytic functional defects were found in AP subjects. A statistically significant percentage of CD14+ CD16+ and CD45RA monocytes were found in AP subjects as compared with the normal control and CP groups.
Journal of Clinical Periodontology, 2004
Background: Thrombotic thrombocytopenic purpura (TTP) is a rare haematological disease of unknown aetiology. This thrombotic microangiopathy is characterized by microvascular lesions with platelet aggregation. It is found in adults and can be associated with pregnancy, cancer, autoimmune diseases, bone marrow transplantation, drugs and bacterial as well as viral infections. The therapy requires a multidisciplinary team approach involving dentistry. Even if TTP is immediately treated in an adequate manner, it still shows a mortality of up to 20%. Aim: To define a specific treatment concept for periodontal disease and decayed teeth in patients suffering from TTP based on the experiences gained from two cases. Conclusion: The two patient cases revealed a possible association of TTP with dental foci. Because of the severity and mortality of this disease, both prognosis evaluation and treatment standards of periodontologically compromised or decayed teeth have to be strictly followed in patients suffering from TTP. In order to avoid recurrence of TTP, it seems important to remove radically teeth of questionable prognosis.
Platelet Gel in the treatment of generalized aggressive periodontitis: A case report
IP International Journal of Periodontology and Implantology
Aggressive periodontitis is a less prevalent, multifactorial disease which characteristically results rapid destruction of periodontium and early tooth loss. This is more frequently seen in systemically healthy younger age group of patients. Aggressive periodontitis can manifest in localized or generalized form. Generalized aggressive periodontitis is clinically characterized by loss of interproximal attachment of at least three permanent teeth apart from first molars and incisors. Conventional surgical procedure with autologous platelet Gel and systemic antibiotics were used successfully to treat and manage this case of generalized aggressive periodontitis.