Professional paper
https://doi.org/10.15644/asc52/4/10
Oral Manifestation as the Main Sign of an Advanced Stage Acute promyelocytic Leukemia
Bianca Piscinato Piedade Rosa
; Department of Oral Medicine University Estadual de Londrina. Rua Pernambuco 540, Londrina-PR. Brasil
Fábio Augusto Ito
; Department of Oral Medicine University Estadual de Londrina. Rua Pernambuco 540, Londrina-PR. Brasil
Fausto Celso Trigo
; Departamento de Clínica Médica – Universidade Estadual de Londrina. Av. Robert Koch 60, Londrian-PR. Brasil
Lauro Toyoshi Mizuno
; Department of Oral Medicine University Estadual de Londrina. Rua Pernambuco 540, Londrina-PR. Brasil
Ademar Takahama Junior
; Department of Oral Medicine University Estadual de Londrina. Rua Pernambuco 540, Londrina-PR. Brasil
Abstract
Acute myeloid leukemia is an aggressive malignant neoplasm occurring mainly in elderly, with the median age of 65 years. Oral manifestations, mainly spontaneous bleeding, are a common finding in acute myelocytic leukemia and may represent the initial evidence of the disease. This report describes a case of a 47-year-old man with a one-month history of spontaneous oral bleeding. The patient had already been consulted by two professionals but he remained undiagnosed. The physical examination revealed paleness, fever, epistaxis and ecchymoses in the oral mucosa. The complete blood count revealed anemia, severe thrombocytopenia and leukocytosis with blasts predominance, reinforcing the diagnosis hypothesis of an acute leukemia. The patient was immediately referred to the Hospital and despite having received a quick intervention, he died 3 days after the admission due to diffuse pulmonary alveolar hemorrhage. According to the peripheral blood immunophenotyping the diagnosis of hypogranular variant of acute promyelocytic leukemia was established. The delay in the diagnosis may have influenced the unfavorable outcome. Early diagnosis and management are indispensable for survival of leukemia patients. In this way, dentists may be responsible for an early detection of oral manifestations of leukemia and for a fast referral to an adequate professional.
Keywords
Leukemia, Promyelocytic, Acute; Oral Manifestations; Oral Hemorrhage; Delayed Diagnosis
Hrčak ID:
213609
URI
Publication date:
19.12.2018.
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