Conrotto Davide, Broccoletti Roberto, Carcieri Paola, Giaccone Luisa, Arduino Paolo G
Department of Surgical Sciences, Oral Medicine Section, CIR Dental School, University of Turin, Via Nizza 230, 10126 Turin, Italy.
Division of Haematology, Azienda Ospedaliera Città della Salute e della Scienza, University of Turin, Corso Bramante 88, 10126 Turin, Italy.
Case Rep Dent. 2014;2014:127219. doi: 10.1155/2014/127219. Epub 2014 Jan 2.
Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.
背景。慢性移植物抗宿主病（cGVHD）是骨髓移植后的一种并发症。系统性药物治疗难以控制口腔病变。病例描述。一名63岁女性患者，因急性髓系白血病接受了异基因移植，发生了慢性口腔和皮肤移植物抗宿主病。患者接受了0.1%的局部他克莫司治疗，每天两次，持续两个月，并接受了一个口腔卫生方案，包括3次洁治、根面平整和每日口腔卫生指导。患者牙龈病变明显消退，相关疼痛和牙龈炎症指标显著改善。临床意义。本病例报告表明，局部他克莫司治疗和专业口腔卫生措施可能有助于管理严重牙龈受累的慢性口腔移植物抗宿主病。
