Abstract
A dialysis patient who showed gingival hyperplasia with calcium-antagonists, nifedipine (NFD) and manidipine (MND), is reported. A 64-year-old male who had received maintenance hemodialysis for 12 years was given antihypertensive therapy with NFD. Painless gingival hyperplasia developed one year later and NFD was discontinued after a further 7 months of administration. After MND was administered instead, gingival hyperplasia was alleviated transiently but was aggravated after 7 months of the MND therapy.
The prevalence of gingival hyperplasia induced by NFD has been reported to be 6.5-14.7%. Few cases of gingival hyperplasia caused by other calcium-antagonists (diltiazem, nicardipine, verapamil) have been reported and this is the first report of gingival hyperplasia induced by MND. The principal mechanism for gingival hyperplasia by calcium-antagonists has been suggested to be accumulation of extracellular matrix because calcium-antagonists decrease the breakdown of collagen due to the decreased influx of calcium ions into fibroblasts. Allergic reaction may be considered as another trigger for the occurrence of gingival hyperplasia.
