Total Extraction as a Treatment for Anaemia in a Patient of Glanzmann's Thrombasthenia with Chronic Gingival Bleed: Case Report ZD11-ZD12
Dr. Abhishek Ghosh,
HCG Cancer Centre Sola-Science City Road, Off S.G. Highway, Sola, Ahmedabad, Gujarat-380060, India.
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Glanzmannâ€™s Thrombasthenia (GT) is a rare autosomal recessive bleeding disorder affecting the megakaryocyte lineage and is characterized by lack of platelet aggregation on stimulation. The molecular basis is linked to quantitative and qualitative abnormalities of aIIbĂź3 integrin. Most of the patients with severe Glanzmannâ€™s thrombasthenia have spontaneous gum bleeding and persistent low haemoglobin levels. Often these patients are addressed with local haemostatic measures and platelet coverage. We report a case of a severe Glanzmannâ€™s thrombasthenia with chronic gingivitis and associated spontaneous gum bleed with chronic low haemoglobin levels, managed subsequently with total dental extraction under appropriate platelet and recombinant factor VIIa coverage. Further follow up of the patient substantiated the treatment protocol with increased and stable haemoglobin levels, thus emphasizing the need for total dental extraction in patients with severe Glanzmannâ€™s with chronic spontaneous gum bleed, as a definitive treatment option, which has not been reported so far in the literature.