Immune thrombocytopenic purpura presenting with spontaneous gingival haemorrhage in pregnancy. Issue 1 (17th January 2019)

• Record Type: Journal Article
• Authors: Dunphy, Louise; Williams, Rhodri
• Is Part Of: BMJ case reports. Volume 12:Issue 1(2019)
• Publication Date: 2019-01-17
• Subjects: dentistry and oral medicine -- haematology (drugs and medicines); Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-228309
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Gingival bleeding is a common intraoral finding, typically associated with inflamed tissues and periodontal disease. It is easily provoked by periodontal probing or toothbrushing. Spontaneous gingival bleeding rarely occurs and may be the only sign of systemic bleeding problems such as thrombocytopenia, leukaemia or coagulopathy. In pregnancy, acute onset of thrombocytopenia may occur in systemic disorders such as severe pre-eclampsia, HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) or the acute fatty liver of pregnancy. The diagnosis and management of such conditions may challenge physicians. It requires a systematic approach with a comprehensive history to exclude causes of gingival haemorrhage such as periodontal disease, anticoagulant therapy, maxillofacial trauma, haematological disorders or a bacterial infection. The authors describe a case of immune thrombocytopenic purpura presenting with spontaneous gingival haemorrhage in pregnancy. This case highlights the fact that medical intervention to correct the underlying aberration of haemostasis is necessary for local measures to stop the gingival bleeding successfully.