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Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report
Immune thrombocytopenic purpura (ITP) is an immune-mediated acquired disease found in both adults and children. It is characterized by transient or persistent decreases in the platelet count. We report a case of ITP detected based on oral hemorrhagic symptoms. The patient was a 79-year-old female wi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Journal of Dentistry Shiraz University of Medical Sciences
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960737/ https://www.ncbi.nlm.nih.gov/pubmed/29854891 |
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author | Sugiura, Tsutomu Yamamoto, Kazuhiko Murakami, Kazuhiro Horita, Satoshi Matsusue, Yumiko Nakashima, Chie Kirita, Tadaaki |
author_facet | Sugiura, Tsutomu Yamamoto, Kazuhiko Murakami, Kazuhiro Horita, Satoshi Matsusue, Yumiko Nakashima, Chie Kirita, Tadaaki |
author_sort | Sugiura, Tsutomu |
collection | PubMed |
description | Immune thrombocytopenic purpura (ITP) is an immune-mediated acquired disease found in both adults and children. It is characterized by transient or persistent decreases in the platelet count. We report a case of ITP detected based on oral hemorrhagic symptoms. The patient was a 79-year-old female with no significant past medical history. She presented with sudden onset of gingival bleeding and hemorrhagic bullae on the buccal mucosa. Gingival bleeding was difficult to control. Laboratory tests revealed severe thrombocytopenia with a platelet count as low as 2000/μL. Under a provisional diagnosis of a hematological disorder, she was referred to a hematologist. A peripheral smear showed normal-sized platelets. A bone marrow examination revealed increased numbers of megakaryocytes without morphologic abnormalities. The patient was diagnosed with ITP and treated with a combination of pulsed steroid therapy and high-dose immunoglobulin therapy. However, her severe thrombocytopenia was refractory to these treatments. Then, a thrombopoietin receptor agonist was begun as a second-line treatment. Her platelets rapidly increased, and no bleeding complications were reported. Because oral symptoms can be one of the initial manifestations of ITP, dentists should be familiar with the clinical appearance of ITP, and attention must be paid to detect and diagnose unidentified cases. |
format | Online Article Text |
id | pubmed-5960737 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Journal of Dentistry Shiraz University of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-59607372018-06-01 Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report Sugiura, Tsutomu Yamamoto, Kazuhiko Murakami, Kazuhiro Horita, Satoshi Matsusue, Yumiko Nakashima, Chie Kirita, Tadaaki J Dent (Shiraz) Case Reports Immune thrombocytopenic purpura (ITP) is an immune-mediated acquired disease found in both adults and children. It is characterized by transient or persistent decreases in the platelet count. We report a case of ITP detected based on oral hemorrhagic symptoms. The patient was a 79-year-old female with no significant past medical history. She presented with sudden onset of gingival bleeding and hemorrhagic bullae on the buccal mucosa. Gingival bleeding was difficult to control. Laboratory tests revealed severe thrombocytopenia with a platelet count as low as 2000/μL. Under a provisional diagnosis of a hematological disorder, she was referred to a hematologist. A peripheral smear showed normal-sized platelets. A bone marrow examination revealed increased numbers of megakaryocytes without morphologic abnormalities. The patient was diagnosed with ITP and treated with a combination of pulsed steroid therapy and high-dose immunoglobulin therapy. However, her severe thrombocytopenia was refractory to these treatments. Then, a thrombopoietin receptor agonist was begun as a second-line treatment. Her platelets rapidly increased, and no bleeding complications were reported. Because oral symptoms can be one of the initial manifestations of ITP, dentists should be familiar with the clinical appearance of ITP, and attention must be paid to detect and diagnose unidentified cases. Journal of Dentistry Shiraz University of Medical Sciences 2018-06 /pmc/articles/PMC5960737/ /pubmed/29854891 Text en Copyright: © Journal of Dentistry Shiraz University of Medical Sciences http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Reports Sugiura, Tsutomu Yamamoto, Kazuhiko Murakami, Kazuhiro Horita, Satoshi Matsusue, Yumiko Nakashima, Chie Kirita, Tadaaki Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report |
title | Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report
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title_full | Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report
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title_fullStr | Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report
|
title_full_unstemmed | Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report
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title_short | Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report
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title_sort | immune thrombocytopenic purpura detected with oral hemorrhage: a case report |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960737/ https://www.ncbi.nlm.nih.gov/pubmed/29854891 |
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