Abstract
Patients with platelet-mediated disorders often present clinical manifestations of bruising and bleeding. Although these changes are detected most frequently on the skin, the oral cavity also may exhibit signs of bleeding. In this report, we describe a patient who presented isolated oral features of hemorrhagic bullae with bleeding, indicative of a bleeding disorder. Results of laboratory tests revealed severe thrombocytopenia and a careful history disclosed dengue fever as the cause. The importance of recognizing the oral manifestations of thrombocytopenia is highlighted here, since the oral cavity is a frequent site of hemorrhage and could be the only manifestation of the disease.
thrombocytopenia; platelet disorder; dengue fever
-
1Cleveland DB, Rinaggio J. Oral and maxillofacial manifestations of systemic and generalized disease. Endodontic Topics. 2003; 4: 69-90.
-
2Nicki RC, Brian RW, Stuart HR, editors. Davidson's principles and practice of medicine. 21th ed. Churchill Living Stone Elsevier; 2010.
-
3Schlosser BJ, Pirigyi M, Mirowski GW. Oral manifestations of hematologic and nutritional diseases. Otolaryngol Clin N Am. 2011;44: 183-203.
-
4Eisen D, Essell J. Drug-induced thrombocytopenia presenting with isolated oral lesions: report of two cases. Cutis. 1998; 62: 193-5.
-
5Thomas EA, John M, Kanish B. Mucocutaneous manifestations of dengue fever. Indian J Dermatol. 2010; 55: 79-85.
-
6World Health Organization: Dengue and dengue haemorrhagic fever. Factsheet n.117. Genebra: WHO; 2002.
-
7Jardim DL, Tsukumo DM, Angerami RN, Carvalho Filho MA, Saad MJ. Autoimmune features caused by dengue fever: a case report. Braz J Infect Dis. 2012; 16: 92-5.
-
8Chuansumrit A, Tangnararatchakit K. Pathophysiology and management of dengue haemorrhagic fever. Transfus Altern Transfus Med. 2006; 8: 3-11.
-
9Dengue: profile of haematological and biochemical dynamics. Rev Bras Hematol Hemoter. 2012; 34: 36-41.
-
10Eisen D, Essell J. Drug-induced thrombocytopenia presenting with isolated oral lesions: report of two cases. Cutis. 1998; 62: 193-5.
-
11James WD, Guiry CC, Grote WR. Acute idiopathic thrombocytopenic purpura. Oral Surg Oral Med Oral Pathol. 1984; 57: 149-51.
-
12Helms AE, Schaffer RI. Idiopathic thrombocytopenic purpura with black oral mucosal lesions. Cutis. 2007; 79: 456-8.
-
13Shivbalan S, Anandnathan K, Balasubramanian S, Datta M, Amalraj E. Predictors of spontaneous bleeding in Dengue. Indian J Pediatr. 2004; 71: 33-6.
-
14Chairulfatah A, Setiabudi D, Agoes R, Colebunder R. Thrombocytopenia and platelet transfusions in dengue Haemorrhagic Fever and Dengue Shock Syndrome. WHO Dengue Bulletin. 2003; 27: 141-3.
-
15Lei HY, Huang KJ, Lin YS. Immunopathogenesis of dengue haemorrhagic fever. Am J Infect Dis. 2008; 4: 1-9.
-
16Vaughn DW, Green S, Kalayanarooj S, Innis BL, Nimmannitya S, Suntayakorn S et al. Dengue viremia titer, antibody response pattern and virus serotype correlate with disease severity. J Infect Dis. 2000; 181: 2-9.
-
17Greenberg MS, Glick M, editors. Burket's oral medicine: diagnosis and treatment. 11th ed. Lewiston, NY: B.C. Decker; 2008.
-
18Drews RE. Critical issues in haematology: anaemia, thrombocytopenia, coagulopathy, and blood product transfusions in critically ill patients. Clin Chest Med. 2003; 24: 607-22.
Publication Dates
-
Publication in this collection
28 Oct 2013 -
Date of issue
Sept 2013
History
-
Received
10 Dec 2013 -
Accepted
12 Apr 2013