Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report

Masahiko Okubo; Tsuyoshi Sato

doi:doi:10.11648/j.ijdm.20230901.11

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Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report

Masahiko Okubo, Tsuyoshi Sato

Published in International Journal of Dental Medicine (Volume 9, Issue 1)

Received: 13 January 2023 Accepted: 14 February 2023 Published: 3 March 2023

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Abstract

Immune thrombocytopenia (ITP) is an autoimmune disease defined as decreased platelet count which is caused by antiplatelet autoantibodies. Here we present a case of elderly patient who exhibited petechiae in oral mucosa and forearm which was found by the dentist and subsequently diagnosed as ITP by the hematologist. An 89-year-old male who had a chief complaint of the problem about his denture visited a general dental practitioner. As the dentist noticed the lesion like a hematoma on the left side of the tongue, he was introduced to our hospital. His medical history revealed that he had undergone the operation of stoma 20 years ago. He had full maxillary and mandibular dentures, but did not recall biting his tongue on his own. On physical examination, soft dark purple hematomas on the bilateral side of the tongue. We initially suspected a traumatic hematoma. However, multiple petechial hemorrhages were present on the oral mucosa, namely, subcutaneous hemorrhages on the palate and the bilateral buccal mucosa. Moreover, when the extremities were checked, some purpura were observed. Laboratory data showed the following: platelet 18,000 /μL. We consulted with the hematologist. A thorough examination revealed that the patient had ITP. Dentists should consider the possibility of encountering unaware ITP patients.

Published in	International Journal of Dental Medicine (Volume 9, Issue 1)
DOI	10.11648/j.ijdm.20230901.11
Page(s)	1-5
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2023. Published by Science Publishing Group

Keywords

Immune Thrombocytopenia, Initial Identification, Bilateral Tongue Bite, Etechiae

References

[1]	Zainal A, Salama A, Alweis R. Immune thrombocytopenic purpura. J Community Hosp Intern Med Perspect. 2019, 9 (1): 59-61.
[2]	Kühne T, Berchtold W, Michaels LA, Wu R, Donato H, Espina B, Tamary H, Rodeghiero F, Chitlur M, Rischewski J, Imbach P; Intercontinental Cooperative ITP Study Group. Newly diagnosed immune thrombocytopenia in children and adults: a comparative prospective observational registry of the Intercontinental Cooperative Immune Thrombocytopenia Study Group. Haematologica. 2011, 96 (12): 1831-1837.
[3]	Cooper N, Ghanima W. Immune Thrombocytopenia. N Engl J Med. 2019, 381 (10): 945-955.
[4]	Terrell DR, Neunert CE, Cooper N, Heitink-Pollé KM, Kruse C, Imbach P, Kühne T, Ghanima W. Immune Thrombocytopenia (ITP): Current Limitations in Patient Management. Medicina (Kaunas). 2020, 56 (12): 667.
[5]	Takeuchi H, Okamoto A. Helicobacter pylori Infection and Chronic Immune Thrombocytopenia. J Clin Med. 2022, 11 (16): 4822.
[6]	Godeau B, Provan D, Bussel J. Immune thrombocytopenic purpura in adults. Curr Opin Hematol. 2007, 14 (5): 535-556.
[7]	Bussel JB, Szatrowski TP. Uses of intravenous gammaglobulin in immune hematologic disease. Immunol Invest. 1995, 24 (1-2): 451-456.
[8]	Kashiwagi H, Kuwana M, Hato T, Takafuta T, Fujimura K, Kurata Y, Murata M, Tomiyama Y; Committee for the Revision of “Reference Guide for Management of adult ITP” Blood Coagulation Abnormalities Research Team, Research on Rare and Intractable Disease supported by Health, Labour and Welfare Science Research Grants. Reference guide for management of adult immune thrombocytopenia in Japan: 2019 Revision. Int J Hematol. 2020, 111 (3): 329-351.
[9]	Schattner E, Bussel J. Mortality in immune thrombocytopenic purpura: report of seven cases and consideration of prognostic indicators. Am J Hematol. 1994, 46 (2): 120-126.
[10]	Lanza A, Di Spirito F, Petrosino S, Sbordone L. Oral Healthcare and Idiopathic Thrombocytopenic Purpura: Early Recognition, Dental Management and Case Report. Dent J (Basel). 2021, 9 (9): 108.
[11]	Sugiura T, Yamamoto K, Murakami K, Horita S, Matsusue Y, Nakashima C, Kirita T. Immune Thrombocytopenic Purpura Detected with Oral Hemorrhage: a Case Report. J Dent (Shiraz). 2018, 19 (2): 159-163.
[12]	Sangwan A, Tewari S, Narula SC, Sharma RK, Sangwan P. Significance of periodontal health in primary immune thrombocytopenia- a case report and review of literature. J Dent (Tehran). 2013, 10 (2): 197-202.
[13]	James WD, Guiry CC, Grote WR. Acute idiopathic thrombocytopenic purpura. Oral Surg Oral Med Oral Pathol. 1984, 57 (2): 149-151.
[14]	Patholton LL, Ship JA. Treatment of patients with bleeding disorders. Dent Clin North Am. 1994, 38 (3): 465-482.
[15]	Kurata Y, Fujimura K, Kuwana M, Tomiyama Y, Murata M. Epidemiology of primary immune thrombocytopenia in children and adults in Japan: a population-based study and literature review. Int J Hematol. 2011, 93: 329-335.
[16]	Vaisman B, Medina AC, Ramirez G. Dental treatment for children with chronic idiopathic thrombocytopaenic purpura: a report of two cases. Int J Paediatr Dent. 2004, 14: 355-362.
[17]	Amiri M. Impact of Helicobacter pylori Eradication Therapy on Platelet Counts in Patients With Chronic Idiopathic Thrombocytopenic Purpura. Glob J Health Sci. 2015, 8: 35-40.
[18]	Hamada M, Nomura R, Matayoshi S, Ogaya Y, Kameyama H, Uzawa N, Nakano K. Detection of Helicobacter pylori from Extracted Teeth of a Patient with Idiopathic Thrombocytopenic Purpura. Microorganisms. 2022, 10 (11): 2285.
[19]	Martini MZ, Lopez JS Jr, Gendler JL, da Fonseca EV, Soares HA, Franzi SA. Idiopathic thrombocytopenic purpura presenting as post-extraction hemorrhage. J Contemp Dent Pract. 2007, 8 (6): 43-49.
[20]	Di Spirito F, Iacono VJ, Alfredo I, Alessandra A, Sbordone L, Lanza A. Evidence-based Recommendations on Periodontal Practice and the Management of Periodontal Patients During and after the COVID-19 Era: Challenging Infectious Diseases Spread by Airborne Transmission. Open Dent J. 2021, 15: 325-336.

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APA Style

Masahiko Okubo, Tsuyoshi Sato. (2023). Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report. International Journal of Dental Medicine, 9(1), 1-5. https://doi.org/10.11648/j.ijdm.20230901.11

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ACS Style

Masahiko Okubo; Tsuyoshi Sato. Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report. Int. J. Dent. Med. 2023, 9(1), 1-5. doi: 10.11648/j.ijdm.20230901.11

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AMA Style

Masahiko Okubo, Tsuyoshi Sato. Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report. Int J Dent Med. 2023;9(1):1-5. doi: 10.11648/j.ijdm.20230901.11

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@article{10.11648/j.ijdm.20230901.11,
  author = {Masahiko Okubo and Tsuyoshi Sato},
  title = {Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report},
  journal = {International Journal of Dental Medicine},
  volume = {9},
  number = {1},
  pages = {1-5},
  doi = {10.11648/j.ijdm.20230901.11},
  url = {https://doi.org/10.11648/j.ijdm.20230901.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijdm.20230901.11},
  abstract = {Immune thrombocytopenia (ITP) is an autoimmune disease defined as decreased platelet count which is caused by antiplatelet autoantibodies. Here we present a case of elderly patient who exhibited petechiae in oral mucosa and forearm which was found by the dentist and subsequently diagnosed as ITP by the hematologist. An 89-year-old male who had a chief complaint of the problem about his denture visited a general dental practitioner. As the dentist noticed the lesion like a hematoma on the left side of the tongue, he was introduced to our hospital. His medical history revealed that he had undergone the operation of stoma 20 years ago. He had full maxillary and mandibular dentures, but did not recall biting his tongue on his own. On physical examination, soft dark purple hematomas on the bilateral side of the tongue. We initially suspected a traumatic hematoma. However, multiple petechial hemorrhages were present on the oral mucosa, namely, subcutaneous hemorrhages on the palate and the bilateral buccal mucosa. Moreover, when the extremities were checked, some purpura were observed. Laboratory data showed the following: platelet 18,000 /μL. We consulted with the hematologist. A thorough examination revealed that the patient had ITP. Dentists should consider the possibility of encountering unaware ITP patients.},
 year = {2023}
}

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TY - JOUR
T1 - Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report
AU - Masahiko Okubo
AU - Tsuyoshi Sato
Y1 - 2023/03/03
PY - 2023
N1 - https://doi.org/10.11648/j.ijdm.20230901.11
DO - 10.11648/j.ijdm.20230901.11
T2 - International Journal of Dental Medicine
JF - International Journal of Dental Medicine
JO - International Journal of Dental Medicine
SP - 1
EP - 5
PB - Science Publishing Group
SN - 2472-1387
UR - https://doi.org/10.11648/j.ijdm.20230901.11
AB - Immune thrombocytopenia (ITP) is an autoimmune disease defined as decreased platelet count which is caused by antiplatelet autoantibodies. Here we present a case of elderly patient who exhibited petechiae in oral mucosa and forearm which was found by the dentist and subsequently diagnosed as ITP by the hematologist. An 89-year-old male who had a chief complaint of the problem about his denture visited a general dental practitioner. As the dentist noticed the lesion like a hematoma on the left side of the tongue, he was introduced to our hospital. His medical history revealed that he had undergone the operation of stoma 20 years ago. He had full maxillary and mandibular dentures, but did not recall biting his tongue on his own. On physical examination, soft dark purple hematomas on the bilateral side of the tongue. We initially suspected a traumatic hematoma. However, multiple petechial hemorrhages were present on the oral mucosa, namely, subcutaneous hemorrhages on the palate and the bilateral buccal mucosa. Moreover, when the extremities were checked, some purpura were observed. Laboratory data showed the following: platelet 18,000 /μL. We consulted with the hematologist. A thorough examination revealed that the patient had ITP. Dentists should consider the possibility of encountering unaware ITP patients.
VL - 9
IS - 1
ER -

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Author Information

Masahiko Okubo

Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan
Tsuyoshi Sato

Department of Oral and Maxillofacial Surgery, Saitama Medical University, Saitama, Japan

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Plain Text BibTeX RIS

APA Style

Masahiko Okubo, Tsuyoshi Sato. (2023). Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report. International Journal of Dental Medicine, 9(1), 1-5. https://doi.org/10.11648/j.ijdm.20230901.11

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ACS Style

Masahiko Okubo; Tsuyoshi Sato. Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report. Int. J. Dent. Med. 2023, 9(1), 1-5. doi: 10.11648/j.ijdm.20230901.11

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AMA Style

Masahiko Okubo, Tsuyoshi Sato. Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report. Int J Dent Med. 2023;9(1):1-5. doi: 10.11648/j.ijdm.20230901.11

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@article{10.11648/j.ijdm.20230901.11,
  author = {Masahiko Okubo and Tsuyoshi Sato},
  title = {Initial Identification of Immune Thrombocytopenia by a Dentist: A Case Report},
  journal = {International Journal of Dental Medicine},
  volume = {9},
  number = {1},
  pages = {1-5},
  doi = {10.11648/j.ijdm.20230901.11},
  url = {https://doi.org/10.11648/j.ijdm.20230901.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijdm.20230901.11},
  abstract = {Immune thrombocytopenia (ITP) is an autoimmune disease defined as decreased platelet count which is caused by antiplatelet autoantibodies. Here we present a case of elderly patient who exhibited petechiae in oral mucosa and forearm which was found by the dentist and subsequently diagnosed as ITP by the hematologist. An 89-year-old male who had a chief complaint of the problem about his denture visited a general dental practitioner. As the dentist noticed the lesion like a hematoma on the left side of the tongue, he was introduced to our hospital. His medical history revealed that he had undergone the operation of stoma 20 years ago. He had full maxillary and mandibular dentures, but did not recall biting his tongue on his own. On physical examination, soft dark purple hematomas on the bilateral side of the tongue. We initially suspected a traumatic hematoma. However, multiple petechial hemorrhages were present on the oral mucosa, namely, subcutaneous hemorrhages on the palate and the bilateral buccal mucosa. Moreover, when the extremities were checked, some purpura were observed. Laboratory data showed the following: platelet 18,000 /μL. We consulted with the hematologist. A thorough examination revealed that the patient had ITP. Dentists should consider the possibility of encountering unaware ITP patients.},
 year = {2023}
}

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