Maxillofacial Plastic and Reconstructive Surgery

  • Volume 40
  • /
  • Pages.39.1-39.7
  • /
  • 2018
  • /
  • 2288-8101(pISSN)
  • /
  • 2288-8586(eISSN)
Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지
DOI QR코드

DOI QR Code

Life-threating outcomes after dental implantation in patient with idiopathic thrombocytopenic purpura: a case report and review of literature

  • Lee, Sung-Tak (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Kim, Jin-Wook (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University) ;
  • Kwon, Tae-Geon (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University)
  • Received : 2018.10.09
  • Accepted : 2018.10.30
  • Published : 2018.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Patients with chronic ITP (idiopathic thrombocytopenia) frequently do not require comprehensive medication for daily life. Usually, it had been regarded that postoperative bleeding after a simple or surgical extraction is easily controlled by simple local measures even in patients with ITP. This lack of regular medication usage can sometimes lead practitioners or patients to underestimate the potential life-threatening risk of ITP. There had been no report on postoperative hemorrhage in a patient with ITP related to dental implant surgery. Case presentation: This report presented a life-threatening postoperative hemorrhage after dental implant surgery in an adult with chronic ITP and subsequent emergency management after severe bleeding and airway compromise. Conclusion: The presented case emphasizes the thorough hematological evaluation of the patients even for patients who do not take any specific medications for asymptomatic, chronic ITP.

Keywords

References

  1. Bonaccio M, Di Castelnuovo A, Costanzo S, De Curtis A, Donati MB, Cerletti C, de Gaetano G, Iacoviello L (2016) Age-sex-specific ranges of platelet count and all-cause mortality: prospective findings from the MOLI-SANI study. Blood 127:1614-1616 https://doi.org/10.1182/blood-2016-01-692814
  2. George JN, Woolf SH, Raskob GE, Wasser JS, Aledort LM, Ballem PJ, Blanchette VS, Bussel JB, Cines DB, Kelton JG, Lichtin AE, McMillan R, Okerbloom JA, Regan DH, Warrier I (1996) Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. Blood 88:3-40 https://doi.org/10.1182/blood.V88.1.3.3
  3. Cortelazzo S, Finazzi G, Buelli M, Molteni A, Viero P, Barbui T (1991) High risk of severe bleeding in aged patients with chronic idiopathic thrombocytopenic purpura. Blood 77:31-33 https://doi.org/10.1182/blood.V77.1.31.31
  4. Cines DB, Blanchette VS (2002) Immune thrombocytopenic purpura. N Engl J Med 346:995-1008 https://doi.org/10.1056/NEJMra010501
  5. Reich W, Kriwalsky MS, Wolf HH, Schubert J (2009) Bleeding complications after oral surgery in outpatients with compromised haemostasis: incidence and management. Oral Maxillofac Surg 13:73-77 https://doi.org/10.1007/s10006-009-0154-8
  6. Givol N, Goldstein G, Peleg O, Shenkman B, Zimran A, Elstein D, Kenet G (2012) Thrombocytopenia and bleeding in dental procedures of patients with Gaucher disease. Haemophilia 18:117-121 https://doi.org/10.1111/j.1365-2516.2011.02540.x
  7. Martini MZ, Lopez JS Jr, Gendler JL, da Fonseca EV, Soares HA, Franzi SA (2007) Idiopathic thrombocytopenic purpura presenting as post-extraction hemorrhage. J Contemp Dent Pract 8:43-49
  8. Cohen YC, Djulbegovic B, Shamai-Lubovitz O, Mozes B (2000) The bleeding risk and natural history of idiopathic thrombocytopenic purpura in patients with persistent low platelet counts. Arch Intern Med 160:1630-1638 https://doi.org/10.1001/archinte.160.11.1630
  9. Fillmore WJ, Leavitt BD, Arce K (2013) Dental extraction in the thrombocytopenic patient is safe and complications are easily managed. J Oral Maxillofac Surg 71:1647-1652 https://doi.org/10.1016/j.joms.2013.05.011
  10. Tarantino MD, Fogarty PF, Shah P, Brainsky A (2015) Dental procedures in 24 patients with chronic immune thrombocytopenia in prospective clinical studies of eltrombopag. Platelets 26:93-96 https://doi.org/10.3109/09537104.2013.870333
  11. Chen T, Chen Z, Zhang S, Zhang K, Wang L (2015) Development and validation of a LC-MS/MS method for quantification of hetrombopag for pharmacokinetics study. Springerplus 4:652 https://doi.org/10.1186/s40064-015-1446-0
  12. Tomljenovic B, Herrmann S, Filippi A, Kuhl S (2016) Life-threatening hemorrhage associated with dental implant surgery: a review of the literature. Clin Oral Implants Res 27:1079-1084 https://doi.org/10.1111/clr.12685
  13. Dubois L, de Lange J, Baas E, Van Ingen J (2010) Excessive bleeding in the floor of the mouth after endosseus implant placement: a report of two cases. Int J Oral Maxillofac Surg 39:412-415 https://doi.org/10.1016/j.ijom.2009.07.062
  14. Woo BM, Al-Bustani S, Ueeck BA (2006) Floor of mouth haemorrhage and life-threatening airway obstruction during immediate implant placement in the anterior mandible. Int J Oral Maxillofac Surg 35:961-964 https://doi.org/10.1016/j.ijom.2006.03.020
  15. Nugent D, McMillan R, Nichol JL, Slichter SJ (2009) Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and/or decreased platelet production. Br J Haematol 146:585-596 https://doi.org/10.1111/j.1365-2141.2009.07717.x
  16. Nurden P, Nurden AT (2008) Congenital disorders associated with platelet dysfunctions. Thromb Haemost 99:253-263 https://doi.org/10.1160/TH07-09-0568
  17. Stasi R, Provan D (2004) Management of immune thrombocytopenic purpura in adults. Mayo Clin Proc 79:504-522 https://doi.org/10.4065/79.4.504
  18. Brown SA, Aledort LM, Lee CA, Barrowcliffe TW, Beeton K, Blanchette V, Bolland S, Goddard N, Goodeve A, Hoyer L, Kessler CM, Ljung R, Lollar P, Manco-Johnson M, Mariani G, Peerlinck K, Rivard G (2001) Optimal treatment regimens for patients with bleeding disorders. Haemophilia 7:313-320 https://doi.org/10.1046/j.1365-2516.2001.00525.x
  19. Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, Chong BH, Cines DB, Gernsheimer TB, Godeau B, Grainger J, Greer I, Hunt BJ, Imbach PA, Lyons G, McMillan R, Rodeghiero F, Sanz MA, Tarantino M, Watson S, Young J, Kuter DJ (2010) International consensus report on the investigation and management of primary immune thrombocytopenia. Blood 115:168-186 https://doi.org/10.1182/blood-2009-06-225565
  20. British Committee for Standards in Haematology General Haematology Task F (2013) Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, children and in pregnancy. Br J Haematol 120:574-596
  21. Neunert C, Lim W, Crowther M, Cohen A, Solberg L Jr, Crowther MA (2011) American Society of H. the American Society of Hematology 2011 evidencebased practice guideline for immune thrombocytopenia. Blood 117:4190-4207 https://doi.org/10.1182/blood-2010-08-302984
  22. Provan D, Newland AC (2011) Guidelines for immune thrombocytopenia. N Engl J Med 364:580-581 author reply 581 https://doi.org/10.1056/NEJMc1013806
  23. Portielje JE, Westendorp RG, Kluin-Nelemans HC, Brand A (2001) Morbidity and mortality in adults with idiopathic thrombocytopenic purpura. Blood 97:2549-2554 https://doi.org/10.1182/blood.V97.9.2549
  24. Dougall A, Fiske J (2008) Access to special care dentistry, part 5. Safety. Br Dent J 205:177-190 https://doi.org/10.1038/sj.bdj.2008.693