急性单核细胞型白血病牙龈肿胀1例治疗体会

Impacted Tooth Extraction in Leukemia Patient:Case Report

白血病是造血系统一种原因不明的恶性疾病,急慢性白血病均伴有口腔症状,笔者报告1例左下颌阻生牙拔除后发现白血病的病例。据本病例治疗体会及文献回顾,症状轻微的白血病,其牙龈表现与慢性牙周炎难以区分。术前常规血液检查是提早发现白血病,避免白血病急性期拔牙带来医疗隐患的有效预防方法。

A 37-year-old female patient came to our hospital for extraction of an impacted left mandibular molar, who had suffered with the subsidence of gum swelling and aching and mouth opening limitation after oral administration of metronidazole for 5 days. At the initial visit, the patient declared in good condition without any systemic disease, with a successful tooth extraction history just 6 months before. So the patient was diagnosed as impacted mandibular molar and periodontitis. Under local anesthesia, the extraction of No. 38 site tooth was very successful, with the socket healed well. But, the patient suffered with persisting gingival hyperplasia of bleeding and spots with unexplained low-grade fever, which showed minuteness responses to antibiotics and antipyretic, during the follow up of 1 month. Finally she was diagnosed as leukemia by general check up including blood examination, and underwent professional treatment of leukemia. This case remind us, uncharacteristic leukemia＇s clinical manifestation may be only gingival hyperplasia at early stage, and easy to be misdiagnosis with periodontitis. A general blood examination is necessary in the differential diagnosis, and invasive dental treatments such as extraction, should be forbidden to the leukemia patients without efficient leukemia treatment.