Abstract
We encountered four patients in whom hematologic disease was found through the symptom of oral bleeding.
Case 1: A 14-year-old boy suffered from gingival bleeding. He had been given a diagnosis of gingivitis by a dentist. The patient had a marked bleeding tendency and severe general fatigue at the time of his first medical examination. Compression with a dental splint was applied to the local gingival bleeding, which resulted in successful local hemostasis. He was diagnosed as having acute myelocytic leukemia with disseminated intravascular coagulation.
Case 2: A five-year-old girl was admitted to the Chiba Children's Hospital because of severe gingival hemonhage. The blood platelet count was 0.7*104/μl at at the time of her first medical examination. As a result of several examinations, she was suspected of having idiopathic thrombocytopenic purpura. Compression with a dental splint was applied immediately and γ-globulin was administered once daily for four days. After that, the blood platelet count gradually increased and the severe gingival bleeding was arrested.
Case 3: A one-year-old boy fell down very hard and bit his tongue. The boy was seen at the Chiba Children's Hospital because of persistent mucosal bleeding from the tongue. As a result of several hematologic examinations, he was diagnosed with hemophilia A. The tongue was sutured and VIII factor was administered.
Case 4: An eight-year-old boy was referred to the Chiba Children's Hospital for the treatment of recurring mucosal bleeding. The patient had been treated surgically for alveolar abscess at a dental clinic. By compression with a dental splint, we were able to arrest the bleeding. The patient was diagnosed as having hemophilia B.
Diagnosing hematologic disease merely through the symptom of oral bleeding is difficult. However, attention must be paid to the fact that some patients with oral bleeding have hematologic disease. It is possible that these patients have recurring, severe, or broad mucosal bleeding, or general symptoms such as fever and fatigue.
