RESUMO
Drug-induced gingival overgrowth is a frequently observed adverse effect of antihypertensive drug calcium channel blockers (CCBs). Gingival enlargements are more common with the dihydropyridine class of CCBs. The fourth-generation dihydropyridine CCB Cilnidipine was introduced in 1995 and is used as an antihypertensive agent for patients in the Indian subcontinent. This is the first report in literature to document an isolated case of generalized gingival overgrowth induced by the long-term use of low dose of cilnidipine in an elderly female patient who is under antihypertensive therapy. Gingival overgrowth is an adverse drug reaction of new-generation CCB Cilnidipine when administered even as low-dose antihypertensive therapy agent. Physicians and dentists should identify such late changes in susceptible individuals.
RESUMO
BACKGROUND: Gingival overgrowth (GO) is a known side-effect of calcium channel blockers. Although there have been several case reports, few studies have examined the prevalence of nifedipine, diltiazem, and amlodipine. This study was conducted to determine the prevalence and risk factors for GO in patients treated with calcium channel blockers. MATERIALS AND METHODS: A cross-sectional study was conducted in out patient Department of Medicine, Government Medical College, Calicut. 133 patients taking antihypertensives were examined for the presence of GO using two different indices: Vertical GO in 6 points around each tooth and horizontal Miranda-Brunet index in the interdental area. Gingival index (GI), plaque index, and probing depth were also evaluated. RESULTS: The frequency of GO was significantly higher in nifedipine-treated cases than other drug groups. Frequency of GO was 75% for nifedipine, 31.4% for amlodipine and 25% for amlodipine + metoprolol. Higher gingival, plaque and calculus were observed in patients taking calcium channel blockers. Among the possible risk factors, only the GI showed a significant correlation with GO. CONCLUSIONS: Patients taking antihypertensives had poor oral hygiene. Patients taking nifedipine showed a higher frequency of GO. Gingival inflammation acts as a predisposing factor.
RESUMO
The myelodysplastic syndrome (MDS) is characterized by peripheral blood cytopenias and increased risk of transformation to acute myeloid leukemia. This syndrome affects blood cell production and behavior. MDS is difficult to diagnose because of the absence of symptoms in the early stage of the disease. Often it is accidentally discovered during a routine physical exam/blood test. Till date, only a few cases of gingival enlargement associated with MDS are reported in the literature. Here is a remarkable case of gingival enlargement heralding the presence of MDS.
