Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Case report
Year : 2017 | Month : November | Volume : 11 | Issue : 11 | Page : ZD03 - ZD04

Tooth Extraction in a Hepatic Cirrhosis Patient Receiving the Novel Oral Thrombopoietin Receptor Agonist Lusutrombopag

Shin-ichiro Hiraoka, Kohei Kawamura, Tetsuya Seikai, Tadataka Tsuji, Mikihiko Kogo

1. Assistant Professor, First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan. 2. Graduate Student, First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan. 3. Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan. 4. Clinical Fellow, First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan. 5. The Chair, First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, Suita, Osaka, Japan.

Correspondence Address :
Dr. Shin-ichiro Hiraoka,
Assistant Professor, First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry,
Osaka University, 1-8 Yamada-Oka, Suita, Osaka, Japan.
E-mail: hirashins2@gmail.com

Abstract

Lusutrombopag was administered to a patient with thrombocytopenia due to chronic liver disease before an invasive procedure. Lusutrombopag, the first drug of its kind, was developed to improve platelet count thereby, avoiding the need for platelet transfusion. Lusutrombopag is potentially effective for the management of haemostasis during invasive procedures, such as tooth extraction. Herein, we present a case of tooth extraction surgery in a patient treated with lusutrombopag. The patient was a 63-year-old woman suffering from thrombocytopenia due to liver cirrhosis. Tooth extraction was indicated by the diagnosis of caries and apical periodontitis of the maxillary left second molar. Mild spontaneous bleeding in the surrounding gum tissue and a reduced platelet count (5.1 × 104/µL) were observed. Haemostatic difficulties were predicted to accompany tooth extraction surgery. Consultation with a gastroenterology clinic led us to implement lusutrombopag prior to the procedure. The patient’s platelet count had risen to 10.9 × 104/µL by the day of the surgery. Neither intraoperative nor postoperative bleeding was observed. No adverse events associated with lusutrombopag administration were observed. Lusutrombopag can increase platelet count, suggesting its utility in invasive procedures such as tooth extraction.

Keywords

Liver cirrhosis, Periodontitis, Platelet, Thrombocytopenia

How to cite this article :

Shin-ichiro Hiraoka, Kohei Kawamura, Tetsuya Seikai, Tadataka Tsuji, Mikihiko Kogo. TOOTH EXTRACTION IN A HEPATIC CIRRHOSIS PATIENT RECEIVING THE NOVEL ORAL THROMBOPOIETIN RECEPTOR AGONIST LUSUTROMBOPAG. Journal of Clinical and Diagnostic Research [serial online] 2017 November [cited: 2018 Jan 21 ]; 11:ZD03-ZD04. Available from
http://www.jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=November&volume=11&issue=11&page=ZD03-ZD04&id=10898

DOI and Others

DOI: 10.7860/JCDR/2017/30345.10898

Date of Submission: May 25, 2017
Date of Peer Review: Aug 25, 2017
Date of Acceptance: Sep 26, 2017
Date of Publishing: Nov 01, 2017

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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