Lamotrigine-Induced Gingival Enlargement: An Older Problem Due to a Newer Drug - A Rare Case Report.

INTRODUCTION: Gingival enlargement (GE) due to anti-epileptic drugs (AEDs) shows a high prevalence rate. However, lamotrigine, a newer AED, has not shown to induce GE. The present case report describes a rare case of GE in a patient with epilepsy under lamotrigine therapy for the past 3 years. CASE PRESENTATION: In this report, successful management of lamotrigine-influenced GE in a 24-year-old patient with epilepsy by gingivectomy followed by stringent oral hygiene protocol is presented. CONCLUSION: The present case report suggests that, even this newer AED can cause GE and the oral hygiene status of the patients could be an important triggering factor.

Primary tuberculosis masquerading as gingival enlargement.

Background Tuberculosis is a chronic granulomatous disease and an enormous health problem. Oral lesions are relatively uncommon, however, pulmonary tuberculosis may manifest with the involvement of the gingiva as the only primary finding.Case description The present case study reports tuberculosis of the gingiva manifesting as gingival enlargement. The diagnosis was based on sputum examination, histopathology and immunologic investigations. Anti-tubercular therapy was carried out with remarkable changes in gingival health within four months.Clinical implications and conclusion Gingival tuberculosis is a relatively uncommon occurrence and this case study emphasises the need for the clinician to include tuberculosis in the differential diagnosis of various types of gingival enlargement. Early detection and prompt treatment is the key for management of this highly infectious and communicable disease.

Oral presentation of Wegener granulomatosis.

Although the mouth is often involved in Wegener granulomatosis, oral lesions as the initial sign are rare. This case report documents the importance of considering Wegener granulomatosis in patients with unique oral lesions. The most common lesion is a friable-granular-hyperplastic gingivitis associated with alveolar resorption and tooth mobility. The disease may remain localized to the mouth for several weeks or months before multiorgan involvement occurs. Gingival enlargement is a direct manifestation of Wegener granulomatosis, and it may be pathognomonic. Failure to recognize the clinical lesions can result in delayed diagnosis and treatment, with potentially fatal results.

[Complete clinical remission over 50 months of a patient with acute monocytic leukaemia (author's transl)]. / Remisión clínica completa de 50 meses de evolución en un paciente afecto de leucemia aguda monocítica.

A case of Schilling type pure acute monocytic leukaemia (M5 variety of the FAB classification) in a 38-year-old man is presented. The initial predominant clinical manifestation was an increase hypertrophic gingivitis. The cytological type was established according to the morphologic and cytochemical criteria currently in use. The patient was treated with daunomycin (60 mg/m2 one day) and ARA-C (100 mg/m2/12 hours for 7 days) in a 2-week interval cycles. Total remission was achieved after the fifth series. The series have been repeated over 4 years with intervals of up to 6 or 8 weeks. Complete haematologic remission has been constant, with normalization of the serum muramidase levels. A gingival biopsy taken at the same time has shown no evidence of leukaemic infiltration. The high incidence of malignancy in this cytological variety of acute leukaemia is pointed out; it is normally less sensitive to chemotherapy than the myeloid types. Remission has been total over a long period of time, which is exceptional in this type of leukaemia. The mean survival rate as recorded in the literature is only a little over 3 months.