Necrotizing stomatitis: a possible periodontal manifestation of deferiprone-induced agranulocytosis

Tewari, Shikha; Tewari, Sanjay; Sharma, RK; Abrol, Pankaj; Sen, Rajeev

doi:10.1016/j.tripleo.2009.06.021

Cited by 14 publications

(22 citation statements)

References 34 publications

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“…The administering doctor stopped the DFP for Included in the study 3 months and the symptoms subsided. 5 A second case study by Tewari et al 11 reported a possible periodontal manifestation of agranulocytosis caused by DFP. This patient complained of grayish-white discoloration of his gingiva, followed by tooth pain.…”

Section: Resultsmentioning

confidence: 98%

Side effect of deferiprone as iron chelator in patient with thalassemia

Yosia

Wahidiyat

2017

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Background There are currently three available iron chelators: deferoxamine (DFO), deferasirox (DFX), and deferiprone (DFP). In Dr. Cipto Mangunkusumo Hospital and Indonesia, in general, the accessibility of DFP for thalassemia patients has been adequate. Even though its efficacy in removing iron has been proven by countless studies, questions relating to its safety and possible side effects continue to be raised. Objective To assess common side effects of DFP usage by an intensive literature search and compare them to that in a pediatric thalassemia patient, in order to determine if the child's symptoms were potentially caused by DFP. Methods A literature search using MeSH terms was done in PubMed. Full copies of articles that fulfil the inclusion criteria, based on their title, abstract, and subject descriptors, were critically appraised using The Joanna Brigs Institute (JBI) critical appraisal tools. Results A total of 10 original articles from 1998-2013 were deemed applicable to this study including: 2 case reports, 5 prospective cohort studies, 2 retrospective cohort studies, and 1 randomized control trial with a grand total of 1,026 subjects. Conclusion Side effects of DFP include neutropenia, agranulocytosis, increased ALT, gastrointestinal problems, arthralgia or arthropathy, increased appetite or weight, thrombocytopenia, urine discoloration, as well as auditory and visual disturbances. Our case report patient's symptoms of gum bleeding and haemorrhagic mass are not related to her DFP consumption. [Paediatr Indones. 2017;57:329-36 ; doi: http://dx

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Section: Resultsmentioning

confidence: 98%

Side effect of deferiprone as iron chelator in patient with thalassemia

Yosia

Wahidiyat

2017

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“…A young thalassemic major patient placed on deferiprone to reduce iron overload developed agranulocytosis which resulted in NS [18]. This also demonstrated reduced immunity.…”

Section: Discussionmentioning

confidence: 99%

Necrotizing Stomatitis in a Non-HIV Patient: A Case Presentation

Abah¹,

Agbelusi²

2013

Journal of Case Reports in Medicine

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Necrotizing stomatitis (NS) is an uncommon oral ulceration associated with reduced immunity, recent illness, and unusual life stress. It can be seen in malnourished children and HIV-infected adults, but it is very uncommon in non-HIV adults. Objective. To present a case of NS in a non-HIV adult. Methodology. We present a previously misdiagnosed case of NS in a non-HIV 27-year-old female whose immunity was compromised by several factors including malnutrition, chronic anemia, drug treatment of rheumatoid arthritis, and fibrous TMJ ankylosis. Several factors mitigating the diagnosis and successful treatment of this patient are discussed. Conclusion. This presentation highlights a challenging case of NS complicated by several unusual factors. It serves to educate the dental practitioners on the interplay of factors which if not addressed will mitigate successful management of the patient.

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“…Decreased production of neutrophils is associated with deficiencies of vitamin B12 and folic acid, aplastic anemia, tumors (leukemia, solid tumors that invade bone marrow), drugs, metabolic diseases (glycogen storage disease type 1b, methylomalonic acidaemia), nutritional deficiencies (malnutrition,copper deficiency), radiation injury, immune mechanisms, and heritable genetic aberrations (congenital neutropenia, cyclic neutropenia). Certain infections decrease the number of neutrophils in the circulating blood due to increased migration of neutrophils into the tissue, sequestration of neutrophils, or direct toxic effect of the microorganism and its toxins on the bone marrow (2).…”

Section: Alterations In the Number Or Function Of Leucocytes 1 Leukomentioning

confidence: 99%

“…Acquired agranulocytosis or neutropenia is far more common than congenital forms, often accompanying viral infections, or it may be attributable to drugs in > 70% of cases, which is a rare and potentially life-threatening condition, owing to either myelosuppression or antibody-mediated destruction. Drugs associated with agranulocytosis include antiepileptics, antithyroid drugs (carbimazole, methimazole, and propylthiouracil), antibiotics (penicillin, chloramphenicol, and cotrimoxazole), cytotoxic drugs, gold, nonsteroidal antiinflammatory drugs (indomethacin, naproxen, and phenylbutazone), mebendazole, the antidepressant mirtazapine, and some antipsychotics (clozapine) (2). Also metamizole, a drug frequently prescribed by dentists, may cause agranulocytosis (3).…”

Section: Neutropenias That Can Cause Oral Manifestationsmentioning

confidence: 99%

“…As a consequence, periodontal surgery started to be considered only recently (1). When oral surgical procedures are anticipated, a platelet count of ≥50,000 cells/µL, absolute neutrophil count of ≥500 cells/µL, and hemoglobin concentration of ≥7 g/ dL, are recommended to comfortably assure effective hemostasis and reduce the risk of postoperative bacterial infection (2). Other prophylactic measures to minimize the bacteraemia risk are: antiseptic rinse with clorhexidine prior to any dental treatment, antibiotic administration before and after surgery and the primary closing of the surgical wound (1).…”

Section: Neutropenias That Can Cause Oral Manifestationsmentioning

confidence: 99%

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Oral manifestations and dental management of patient with leukocyte alterations

Franch¹,

Esteve²,

Pérez³

2011

J Clin Exp Dent

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Leukocytes are the main cellular elements of inflammatory and immune reactions of the organism. Leukocyte alterations are the consequence of an imbalance between the formation of leukocytes in the bone marrow and its elimination by the mononuclear phagocytic system. Factors that can modify leukopoyesis are varied and can lead to an alteration in the number of leukocytes or tumoral alterations of white cells (leukemias, lymphomas and plasma cell tumors). There is also a wide range of clinical manifestations that can derive from them: from very slight symptoms to life-threatening conditions. In some cases oral manifestations will be the first signs and it will be the dentist's responsibility to identify the underlying disorder and guide the diagnosis of the patient. It is important to be familiar with the special management required for these patients, in which the dental treatment can affect the course of the underlying disease. The objective of this article is to review the literature concerning the oral manifestations and the considerations that must factor in the dental treatment of patients with leukocyte alterations.

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Necrotizing stomatitis: a possible periodontal manifestation of deferiprone-induced agranulocytosis

Cited by 14 publications

References 34 publications

Side effect of deferiprone as iron chelator in patient with thalassemia

Side effect of deferiprone as iron chelator in patient with thalassemia

Necrotizing Stomatitis in a Non-HIV Patient: A Case Presentation

Oral manifestations and dental management of patient with leukocyte alterations

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