Gingival changes in a drug-induced gingival overgrowth patient using tacrolimus: a case report

Year 2015, Volume: 5 Issue: 1, 75 - 79, 03.05.2015

Neslihan Nal Acar , Leyla Kuru Ulku Noyan

Abstract

This case report presents a 33 year-old female renal transplant recipient who presented to our clinic with her chief complaint of gingival overgrowth. Following clinical and radiographic examinations, she was diagnosed with chronic periodontitis accompanied by cyclosporin A and nifedipine-induced gingival overgrowth. Initial periodontal therapy and replacement of cyclosporin A with tacrolimus, with continued nifedipine usage, were performed. Marked improvements in clinical parameters were observed within 3 months. Bilateral ulcerated lesions which were observed on attached gingiva of the upper and lower premolar regions 2 months after commencement of tacrolimus usage, were histopathologically examined and diagnosed with nonspecific ulcerations. These lesions disappeared within 2 months after the dose of tacrolimus was decreased. In this case report, a renal transplant patient with chronic periodontitis and gingival overgrowth was treated with scaling/root planning and conversion from cyclosporin A to tacrolimus. Ulcerations on the gingiva were assumed to have resulted from tacrolimus usage.

Keywords

Gingival overgrowth, cyclosporin A, tacrolimus

İlaca bağlı dişeti hiperplazisinde takrolimusa bağlı değişimler: Olgu raporu

Abstract

Bu vaka raporu, kliniğimize dişeti büyümesi şikayetiyle başvuran 33 yaşında, kadın, böbrek transplantasyon hastasını sunmaktadır. Klinik ve radyografik muayeneyi takiben, siklosporin A ve nifedipine bağlı dişeti hiperplazisinin eşlik ettiği kronik periodontitis teşhisi koyulmuştur. Başlangıç periodontal tedavinin yanında siklosporin A tacrolimusla değiştirilmiş, nifedipin kullanımına devam edilmiştir. 3 ayda klinik parametrelerde önemli gelişmeler görülmüştür. Tacrolimus kullanımından 2 ay sonra ortaya çıkan ve alt ve üst küçük azı bölgelerinde çift taraflı olarak gözlenen ülsere lezyonlar histopatolojik olarak incelenmiş ve spesifik olmayan ülserasyon olarak değerlendirilmiştir. Lezyonlar tacrolimus dozu azaltıldıktan 2 ay sonra kaybolmuştur. Bu vaka raporunda, kronik periodontitis ve dişeti hiperplazisi görülen böbrek transplantasyon hastası, diştaşı temizliği ve kök yüzeyi düzleştirmeyle birlikte siklosporinin tacrolimusla değiştirilmesiyle tedavi edilmiştir. Dişetindeki ülserasyonların tacrolimus kullanımından kaynaklanabileceği düşünülmüştür.

Keywords

Dişeti büyümesi, siklosporin A, takrolimus

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