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重型β地中海贫血孕妇口腔表现的多学科管理:一例报告

Multidisciplinary Management of Oral Manifestations in Pregnant Women with Beta-Thalassemia Major: A Case Report.

作者信息

Karina Dhini, Fitriasari Nuri, Mandalas Henry Yonatan, Andhika Rizky, Wijaya Indra, Wahyuni Indah Suasani

机构信息

Oral Medicine Residency Program, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia.

Oral Medicine Division, Department of Dental and Oral Health, Hasan Sadikin Hospital, Bandung, Indonesia.

出版信息

Int Med Case Rep J. 2024 Jul 26;17:709-717. doi: 10.2147/IMCRJ.S464296. eCollection 2024.

Abstract

INTRODUCTION

Beta-thalassemia major is a blood disorder caused by impaired synthesis of hemoglobin beta chain. Oral manifestations of beta-thalassemia major in pregnancy have rarely been reported.

OBJECTIVE

This study aimed to describe a case of oral manifestations in a pregnant woman with beta-thalassemia major for multidisciplinary management.

CASE

A 27-year-old woman, suffering from beta thalassemia major who is undergoing therapy in the form of routine blood transfusions every month and taking anti-chelation drugs but is currently stopping this because she is pregnant, currently 16 weeks pregnant, complains complained of swollen gums, bleeding, and bad breath. Extraoral examination revealed dry, exfoliative lips. Intraoral examination revealed gingival hyperplasia with erythema, soft consistency, dark red rounded gingival margins, bleeding, true pockets and pain throughout the labial, buccal, palatal, and lingual. There was no history of systemic disease in this patient. Patient has never visited a dentist, either before or now, with complaints about her oral cavity. Hematological parameters showed abnormalities, and peripheral blood examination revealed an infection. The oral diagnoses included gingival enlargement and chronic periodontitis associated with pregnancy and β- thalassemia major.

CASE MANAGEMENT

Dental management consisted of spooling with 3% hydrogen peroxide (HO) spooling, chlorine dioxide spray mouthwash, antibiotics, calculus removal, and oral hygiene instructions. Blood transfusions were administered once a month, and anti-chelation therapy was stopped during pregnancy. After three months of multidisciplinary management, the results were satisfactory.

CONCLUSION

Multidisciplinary, collaborative dental and medical management with non-surgical therapy of oral manifestations in pregnant women with beta-thalassemia major showed satisfactory results.

摘要

引言

重型β地中海贫血是一种由于血红蛋白β链合成受损引起的血液疾病。关于重型β地中海贫血孕妇口腔表现的报道很少。

目的

本研究旨在描述一例重型β地中海贫血孕妇的口腔表现,以便进行多学科管理。

病例

一名27岁女性,患有重型β地中海贫血,每月接受常规输血治疗并服用抗螯合剂药物,但因怀孕目前已停药,现怀孕16周,主诉牙龈肿胀、出血和口臭。口外检查发现嘴唇干燥、脱屑。口内检查发现牙龈增生伴红斑,质地柔软,牙龈边缘呈暗红色圆形,有出血、真性牙周袋,唇侧、颊侧、腭侧和舌侧均有疼痛。该患者无全身疾病史。患者既往及目前均未因口腔问题看过牙医。血液学参数显示异常,外周血检查发现感染。口腔诊断包括牙龈肿大以及与妊娠和重型β地中海贫血相关的慢性牙周炎。

病例管理

牙科管理包括用3%过氧化氢冲洗、二氧化氯喷雾漱口、使用抗生素、清除牙结石以及进行口腔卫生指导。每月进行一次输血,孕期停止抗螯合治疗。经过三个月的多学科管理,结果令人满意。

结论

对重型β地中海贫血孕妇的口腔表现采用多学科协作的牙科和医学非手术治疗管理,结果令人满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e481/11288352/93e18bbe8456/IMCRJ-17-709-g0001.jpg

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本文引用的文献

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