Acute myelomonocytic leukemia presenting with gingival enlargement as the only clinical manifestation

Abstract

A 34 year old woman reported for evaluation of generalized gingival swelling pain and bleeding. The patient also reported menstrual irregularities. Based on the oral and systemic examinations and hematological investigations, a provisional diagnosis of ‘menstrual cycle associated gingivitis’ was made. The patient was referred for a gynecologic consultation. At the three-week dental recall, a worsening of gingival overgrowth with a necrotic component was noted. The hematologic investigations revealed markedly elevated leukocyte counts. The clinical and hematological findings led us to a diagnosis of leukemia. This report emphasizes the importance of the dentist as well as the physician (in this case, the gynecologist) in correlating the oral, systemic and hematological findings in the diagnosis and also of regular recall in the management of a case.

Gingival leukemic infiltration as the first manifestation of acute myeloid leukemia

“…5 Patient with AML may present with anemia, neutropenia, thrombocytopenia, weakness, easy fatigue, fever, bone pain, infections, bleeding, gingival enlargement, petechiae, ecchymosis, mucosal pallor, and oral ulceration. 3,4,6,7 Leukemic infiltration of the gums can be the first sign of leukemia and the recognition of this is important for early diagnosis of the disease and prognosis. [1][2][3][4][5][6][7][8][9][10][11] This report describes a young girl with AML and whose complaints were confined to gingival overgrowth and bleeding.…”

“…3,4,6,7 Leukemic infiltration of the gums can be the first sign of leukemia and the recognition of this is important for early diagnosis of the disease and prognosis. [1][2][3][4][5][6][7][8][9][10][11] This report describes a young girl with AML and whose complaints were confined to gingival overgrowth and bleeding. This was the first clinical manifestation of the disease and the dentist was responsible for the diagnosis.…”

Manifestação Oral Da Leucemia Mielóide Aguda Como Primeiro Sinal Para O Diagnóstico: Relato De Caso

“…(1,9,10) A leucemia pode ser classificada em aguda e crônica, de acordo com o seu comportamento clí-nico e caracterizada como mieloide e linfoide, de acordo com a sua origem histogenética. (2) As leucemias agudas são marcadas pelo avanço de cé-lulas cancerosas imaturas na medula óssea e no sangue periférico.…”

“…(8) Os sinais e sintomas da leucemia aguda são decorrentes do acúmulo e da proliferação de leucócitos alterados na medula óssea, prejudicando ou impedindo a produção de glóbulos vermelhos (causando anemia, cansaço e palidez das mucosas ou pele), glóbulos brancos (causando neutropenia e aumentando o risco de infecções) e plaquetas (causando trombocitopenia e maior risco de hemorragia). (1,4) O hemograma está quase sempre alterado. Dentre as alterações laboratoriais mais observadas estão à anemia, a trombocitopenia e a presença de blastos na contagem diferencial de leucócitos.…”

O Papel Do Cirurgião-Dentista No Diagnóstico Precoce Da Leucemia E Sua Responsabilidade Ética E Legal – Revisão De Literatura

“…Os primeiros sinais ou sintomas de leucemia frequentemente podem incluir manifestações bucais 5,6 , mais comum nas fases agudas da doença 7 , principalmente na leucemia monocítica 8 , sendo este o motivo do cirurgião-dentista estar envolvido diretamente no diagnóstico da doença, devendo ter conhecimento do momento adequado para a realização de tratamentos odontológicos eventualmente necessários 9,10 . Também pode haver uso de nistatina e bochechos com clorexidina, sendo recomendável a remoção de focos de infecção de origem dentária para se evitar bacteremias [35][36] .…”