engleski

PC032: Paradoxical gingival bleeding in patient with chronic myeloproliferative disease: a case report

Background: Myeloproliferative diseases are a rare heterogeneous group of blood neoplasms characterised by proliferation of one or more haematologic cell lines in the bone marrow without the presence of a definable stimulus, known to be associated with an increased risk for both thrombosis and haemorrhage. This case report describes a 60‐year old woman with medical history of myeloproliferative neoplasm, diagnosed in 2010, referred to the Department of Periodontology for ongoing severe gum bleeding. Contradictory, at the time of the referral, patient presented with trifold increase of normal platelet counts (1, 382, 000/μl). Clinical and radiographic examination revealed soft and friable gingiva, bleeding profusely on slight irritation (overall PBI = 4), FMPS <50%, generalized periodontal pocketing up to 8 mm of depth and horizontal bone loss. Clinical Procedure: Periodontal treatment plan was based on the cooperation of the attending periodontist and hematologist, with the latter adjusting patient's systemic therapy to lower the platelet counts. Following a non‐surgical treatment, repeated oral hygiene instructions and re‐motivation, and upon re‐evaluation, patient presented reduction in depths of periodontal pockets and gingival bleeding (overall PBI = 1.8). Patient continued with supportive periodontal therapy every 3 months. Outcomes: Reported patient presented with both haemorrhagic diathesis and previous thrombotic events. Despite the excessively increased platelet counts, paradoxical bleeding of the gingiva was observed in this patient due to the alteration of platelet function and depletion of coagulation factors. As presented, joint hematologist‐periodontist cooperation, supportive periodontal therapy and patient compliance are of crucial importance in successful long‐term treatment of these patients.

gingival bleeding ; periodontitis ; myeloproliferative disease

nije evidentirano