牙齦異常出血與第七凝血因子缺乏－病例報告

Gingival Bleeding Disorders and Coagulation Factor Ⅶ Deficiency: Case Report

張佑琪(Yu-Chi Chang) ； 陳宛君(Wan-Chun Chen) ； 林益弘(Yi-Hung Lin) ； 盧俊泰(Chun-Tai Lu)

《臺灣牙周病醫學會雜誌》 15卷3期 (2010/09) Pp. 203-213

摘要

A lack of coagulation factor VII leads to abnormal gingival bleeding. We report a 54-year-old lady who visited our Emergent Department because of continuous gingival bleeding in the right posterior quadrant on October 11, 2008. She did not have ally dental treatment or take any drug at that time. The dental check revealed gingivitis with bleeding. Tile prothrombin time (PT) was 20.0 seconds and exceeded the normal range of PT (9.4-11.5 seconds) in our hospital. We consulted the hematologist for detailed evaluation. The final diagnosis was deficiency of coagulation factor Ⅶ. The activity of her factor Ⅶ was 9.8% and fell far below the normal range (65%). The patient accepted oral hygiene instruction first. We then removed the dental plaque to control the gingivitis and extracted those extensively decayed teeth 26.36,48. She had an injection of factor Ⅶ in the Hematology Department before extraction. She did not have intractable bleeding after these dental procedures. Abnormal gingival bleeding is often related to various clotting disorders. In dealing with patients of bleeding gums, we have to carefully inquire the medical history and order the clotting tests whenever indicated. The hematologist can be of help in management of patients with abnormal gingival bleeding.

關鍵字

第七凝血因子 ； 牙齦異常出血

並列摘要

A lack of coagulation factor VII leads to abnormal gingival bleeding. We report a 54-year-old lady who visited our Emergent Department because of continuous gingival bleeding in the right posterior quadrant on October 11, 2008. She did not have ally dental treatment or take any drug at that time. The dental check revealed gingivitis with bleeding. Tile prothrombin time (PT) was 20.0 seconds and exceeded the normal range of PT (9.4-11.5 seconds) in our hospital. We consulted the hematologist for detailed evaluation. The final diagnosis was deficiency of coagulation factor Ⅶ. The activity of her factor Ⅶ was 9.8% and fell far below the normal range (65%). The patient accepted oral hygiene instruction first. We then removed the dental plaque to control the gingivitis and extracted those extensively decayed teeth 26.36,48. She had an injection of factor Ⅶ in the Hematology Department before extraction. She did not have intractable bleeding after these dental procedures. Abnormal gingival bleeding is often related to various clotting disorders. In dealing with patients of bleeding gums, we have to carefully inquire the medical history and order the clotting tests whenever indicated. The hematologist can be of help in management of patients with abnormal gingival bleeding.

並列關鍵字

coagulation factor Ⅶ ； gingival bleeding disorders