Idiopathic thrombocytopenic purpura presenting as gingival bleeding in a Periodontal Clinic in Benin City, Nigeria

Abstract

This is a case of Idiopathic Thrombocytopenic Purpura (ITP) which led to continuous intermittent bleeding
from the gingival sulcus of 11,21, 32, 34, 35, 44, 45, 36. Intraoral examination showed petechiae and
ecchymosis on the lips, buccal mucosa, hard palate and on the ventral surface of the tongue. Petechiae and
black patches on the upper and lower limbs led to the suspicion of altered coagulation or bleeding disorder. A
full blood count revealed pancytopenia (RBC 2.87X 106/ul; WBC 2.5 x103/ul and platelet 9x103/ul). This
emphasizes the significance of a good clinical examination, early diagnosis and referral of such patients to
specialists for prompt treatment. This case report will serve as a guide to dentists that not all gingival
bleeding are due to plaque accumulation that result in gingival inflammation and that some systemic
diseases present with oral manifestations.