Gum hypertrophy in acute myeloid leukemia: an important clinical finding not to be missed
DOI:
https://doi.org/10.18203/2349-3291.ijcp20240744Keywords:
AML, Physical examination, Gum hypertrophyAbstract
Acute myeloid leukaemia (AML) is characterized by disordered differentiation and proliferation of abnormal hematopoietic stem cells. AML usually presents with symptoms of anemia like pallor and fatigue, recurrent infections, petechiae, and mucosal bleeds. Extramedullary infiltration of leukemic cells is a common finding like proptosis or myeloid sarcoma. The occurrence of gingival hypertrophy in the pediatric age group is uncommon and usually due to inflammation followed by prolonged use of certain drugs like cyclosporin or phenytoin. Gingival infiltration in AML is rare in children, usually associated with subtypes M4/M5 (FAB classification). This case report highlights the importance of considering AML as an important differential diagnosis in cases of gum hypertrophy, as being a less common cause, it is often overlooked. Timely diagnosis and prompt treatment can be lifesaving. Here, we report two cases who presented with gum hypertrophy.
References
Orbak R, Orbak Z. Oral condition of patients with leukemia and lymphoma. J Nihon Univ Sch Dent. 1997;39(2):67-70.
Fernandes KS, Gallottini M, Castro T, Amato MF, Lago JS, Braz-Silva PH. Gingival leukemic infiltration as the first manifestation of acute myeloid leukemia. Spec Care Dent. 2018;38(3):160-2.
Krishna KB, Raju PK, Chitturi RR, Smitha G, Vijai S, Srinivas BVV. Prevalence of gingival enlargement in Karnataka school going children. J Int oral Heal. 2014;6(1):106-10.
Lee JY, Chung H, Cho H, Jang JE, Kim Y, Kim SJ, et al. Clinical characteristics and treatment outcomes of isolated myeloid sarcoma without bone marrow involvement: A single-institution experience. Blood Res. 2017;52(3):184-92.
Morais RV de, Souza MV de, Silva KA de S, Santiago P, Lorenzoni MC, Lorea CF, et al. Epidemiological evaluation and survival of children with acute myeloid leukemia. J Pediatr (Rio J). 2021;97(2):204-10.
Arber DA, Orazi A, Hasserjian R, Thiele J, Borowitz MJ, Le Beau MM, et al. The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia. Blood. 2016;127(20):2391-405.
Reenesh M, Munishwar S, Rath SK. Generalised Leukaemic Gingival Enlargement: a Case Report. J Oral Maxillofac Res. 2012;3(3):1-6.
Andréa B, Hermínia C, Mayara T, Gilberto R, Marcos V, Benigna O. Isolated Relapse in the Oral Cavity of a Child with T-lineage Acute Lymphoblastic Leukemia. Braz Dent J. 2012;23:711-5.
Wu J, Fantasia JE, Kaplan R. Oral Manifestations of Acute Myelomonocytic Leukemia: A Case Report and Review of the Classification of Leukemias. J Periodontol. 2002;73(6):664-8.
Gallipoli P, Leach M. Gingival infiltration in acute monoblastic leukaemia. Br Dent J. 2007;203(9):507-9.