Gingival hypertrophy

Published on 02/04/2015 by admin

Filed under Internal Medicine

Last modified 22/04/2025

Print this page

rate 1 star rate 2 star rate 3 star rate 4 star rate 5 star
Your rating: none, Average: 0 (0 votes)

This article have been viewed 1603 times

[level-membership-for-internal-medicine-category]

243 Gingival hypertrophy

Instruction

Look at this patient’s mouth.

Salient features

History

• Drugs (phenytoin, ciclosporin, nifedipine) (Fig. 243.1)

• Leukaemia (myelomonocytic leukaemia) (Fig. 243.2)

• Wegener’s granuloma (Fig. 243.3).

image

Fig. 243.1 Fibrous gingival enlargement associated with phenytoin treatment.

image

Fig. 243.2 Myelogenous leukaemia with neoplastic cellular infiltration of the gingiva and ecchymosis.

image

Fig. 243.3 Wegener’s granulomatosis with necrotizing vasculitis and granulomatous infiltration of gingiva.

Examination

• Hypertrophy of the gums.

Proceed as follows:

• Look for other features of chronic phenytoin therapy: coarsening of facial features, hypertrichosis, hirsutism, generalized lymphadenopathy, rash, cerebellar syndrome, peripheral lymphadenopathy.

Diagnosis

This patient has poor oral hygiene and gingival hypertrophy (lesion) caused by chronic ingestion of phenytoin (aetiology).

Questions

What are the other long-term side effects of phenytoin?

Coarsening of facial features, rashes, SLE, blood dyscrasias, generalized lymphadenopathy, induction of hepatic microsomal enyzmes, folic acid deficiency, peripheral neuropathy, cerebellar syndrome (ataxia, nystagmus and dysarthria), hypertrichosis, osteomalacia and encephalopathy.

When taken during pregnancy, phenytoin may result in cleft lip and palate in the child.

In which types of seizure is phenytoin generally used?

Generalized clonic–tonic seizures.

[/level-membership-for-internal-medicine-category][not-level-membership-for-internal-medicine-category]

243 Gingival hypertrophy

Instruction

Look at this patient’s mouth.

Salient features

History

• Drugs (phenytoin, ciclosporin, nifedipine) (Fig. 243.1)

• Leukaemia (myelomonocytic leukaemia) (Fig. 243.2)

• Wegener’s granuloma (Fig. 243.3).

image

Fig. 243.1 Fibrous gingival enlargement associated with phenytoin treatment.

Buy Membership for Internal Medicine Category to continue reading. Learn more here

[/not-level-membership-for-internal-medicine-category]