Thus, the risk factors are represented by smoking, ionizing radiation exposure, viral infections epstein. Acute myeloblastic leukemia aml is a highly fatal malignant bone marrow disease. Pdf oral manifestations of hematologic and nutritional diseases. The most frequent oral manifestations associated with leukemia are represented by paleness of oral mucosa local abnormal colour of the gum, gingival petechiae. Oral manifestations of leukemia and antineoplastic. Dentists are generally taught that in a significant number of patients with newly diagnosed acute leukemia ndal, the diagnosis may be suspected.
For instance before treatment leukemic infiltrates cause a wide range of oral disease. A number of oral manifestations of systemic disease have been covered previ. Material and methods the subjectrelated research was carried out on the pubmedmedline database. Leukemia is among the most prevalent neoplasia, which represents between 30%51% of that total17. Oral ulcerations as the first manifestations of acute. Oral complications such as gingival enlargement are more frequent in aml than in other types of leukemia, and it is reported that gingival enlargement occurs more frequently in the m4 and m5 subtypes 11. Josephine wu department of dental medicine, division of oral pathology, long island jewish medical center, new hyde park, ny. Physicians, dentists and all other healthcare professionals should be aware of sinister oral signs and symptoms in order to early diagnosis and referral of patients. Here are dental tips to keep your mouth healthy with leukemia. Leukemia is a hematological disorder that is caused by an abnormal increase of immature white blood cells and is often associated with oral manifestations such as mucosal pallor, ecchymoses, bleeding, ulceration, gingival. The effects of diabetes on oral health have been studied extensively. Gingivitis, or swelling and bleeding gums, is a sign of leukemia. Thrombocytopenia is manifested in the oral cavity of petechiae, ecchymosis, and gingival hemorrhage or gingival bleeding 1, 7, 8, 9, 10. The purpose of this study is to report the case of a 49.
The oral manifestations of leucemia can occur on soft tissues and bones. Leukaemia is the most common malignancy in children and one of the most common malignancies in young adults. Volume 29 oral manifestations of leukemia in children 427 number. Introduction abnormal proliferation of blood cells in the bone marrow and blood forming organs lead to a malignant condition commonly referred to as leukemia, which may be classified based on the pace of progression. Additional oral manifestations of lupus erythematosus may include honeycomb plaques silvery white, scarred plaques. Oral manifestations in pediatric patients receiving.
The most frequently observed oral findings of leukemia are mucosal bleeding and ulceration, petechiae, and gingival hyperplasia. Cyclic or periodic neutropenia is an unusual disorder characterized by malaise, fever, oral ulceration with scarring, gingivitis, periodontitis, and disappearance of neutrophils from the blood and bone marrow at approximately 21day intervals. Oral signs of leukemia and dental management literature. The main clinical osteoarticular manifestations in early leukemia include limb pain, nighttime pain, arthralgia, and arthritis. The purpose of this study was to determine the prevalence of oral manifestations in pediatric patients with acute lymphoblastic leukemia all receiving chemotherapy, and to evaluate the significance of independent risk factors oral health, gender, age, time and type of treatment, and phase of chemotherapy. Since oral lesions can be one of the early events of acute myeloid leukaemia. Oral manifestations of acute promyelocytic leukemia. Many are the oral manifestations presented by these patients, arising from leukemia andor treatment. Oral manifestations resulting from chemotherapy in children. Leukemia is a hematological disorder that is caused by an abnormal increase of immature white blood cells and is often associated with oral manifestations such as mu cosal pallor, ecchymoses, bleeding, ulceration, gingival enlargement, trismus, mental nerve neuropathy, facial palsy, and infections 112. According to the type of dominant cells, there are three type of leucemia acute lymphoblastic leukemia, represented by 8085%, acute myelogenous leukemia with 1215%, and chronic leukemia which is represented by 35%.
Oral manifestations in acute leukemia as the first sign. Pdf oral manifestations of hematologic and nutritional. On examination, the oral cavity may exhibit manifesta tions of underlying systemic disease and serve as an indicator of overall health. Systemic diseases with oral findings include autoimmune, hematologic, endocrine, and neoplastic processes. Jun 12, 2016 oral manifestations of systemic diseases 1. In addition, performing dental procedures at different stages of treatment before, during, or after must.
Rare oral mucosal manifestations of hydroxyurea therapy in chronic myeloid leukemia deena mudawi, abdulqadir j nashwan, amna gameel, shehab fareed, mohammad abdulla and mohamed a yassin hematology section, national center for cancer care and research, qatar corresponding authors. Oral manifestations of systemic diseases slideshare. Oral manifestations orofacial manifestations of malignant hematological diseases may present primarily with clinical features due to infiltration of oral soft and hard tissues, subsequent infiltration of bone marrow elements and side effects of treatment being the secondary and tertiary cause. The oral perspective international journal of oral. Dental treatment of patients with leukemia should be planned on the basis of antineoplastic therapy which can be chemotherapy with or without radiotherapy and bone marrow transplantation. Summary patients with leukemia often have ocular manifestations. Early detection of leukemia is very important because it provides a favorable prognosis3,58. However, oral pathologies are more commonly observed in acute leukemia than in chronic leukemia. Skeletal manifestations of acute leukaemia bone or back pain, arthritis or radiographical abnormalities of skeleton are well described in children barbosa et al 2002. Leukemia is characterized by uncontrolled production of immature white blood cells, causing a series of clinical and oral manifestations, which are important in disease diagnosis. Like the systemic manifestations of leukemia, oral changes can be attributed to anemia, granulocytopenia, and thrombocytopenia, all of which result from the replacement of normal bone marrow elements by undifferentiated blast cells or direct invasion of tissue by these leukemic cells. Oral manifestations as an early clinical sign of acute myeloid. Pdf oral ulcerations as the first manifestations of acute. The symptoms include gingival enlargement and bleeding, oral ulceration, petechia, mucosal pallor, noma, trismus and oral infections.
These oral manifestations either may be the result of direct infiltration of. It focuses upon oral mucosal and salivary i gland disorders that may arise as a consequence of systemic disease. Oral manifestations of leukemia in children sciencedirect. Leukemia and oral manifestations linkedin slideshare. Oral manifestations leading to the diagnosis of acute. As a research strategy we employed different combinations of the following key words.
It is not intended to provide details about the diagnosis and management of these conditions. Typical oral manifestations of acute leukaemias include gingival swelling, oral ulceration, spontaneous gingival bleeding, petechiae, mucosal pallor, herpetic infections and. The first signs of leukemia can regularly occur in the oral cavity, especially in the acute phase of cancer, as common lesions at this stage of the disease that can be observed and recognized primarily by the dentist. The oral manifestation of leukemia depend on the general status of patients. Frequently, but by no means constantly, other findings. Ship, dmd, msc doctor lynch is assistant chief of oral medicine, and doctor ship is chief of dental research in the department of dental research, philadelphia general hospital, philadelphia doctor lynch is assistant chief of oral medicine, and doctor ship is chief of dental research in the department of dental research. Tarek sheta lecturer of internal medicine mansoura faculty of medicine 2. Apr 04, 2020 arber da, orazi a, hasserjian r, thiele j, borowitz mj, le beau mm, et al. Oral manifestations leading to the diagnosis of acute lymphoblastic leukemia in a young girl ba silva 1, crb siqueira 2, phs castro 1, ss araujo 1, ler volpato 2 1 department of dentistry, mato grosso cancer hospital, cuiaba, mt, brazil 2 masters program in integrated dental sciences, university of cuiaba, cuiaba, mt, brazil. Arber da, orazi a, hasserjian r, thiele j, borowitz mj, le beau mm, et al.
Oral manifestations as first clinical sign of acute myeloid. The symptoms include gingival enlargement and bleeding. Pdf orofacial manifestation of hematological disorders. Rare oral mucosal manifestations of hydroxyurea therapy in. The 2016 revision to the world health organization classification of myeloid neoplasms and acute leukemia. Oral manifestations of systemic disease 24 general dentistry novemberdecember 2017 or absent, and the oral mucosa may be dry, red, and wrinkled. Oral manifestations of leukemia and antineoplastic treatment. This article is intended as a general overview of conditions with oral manifestations of systemic diseases. Oral manifestations occur frequently in leukemic patients and may present as. Pa tients with acute leukemia who had oral pe techiae or bleeding or oral ulcerations had shortened survival time compared with those patients with no oral. Oral manifestations of myeloid neoplasms and acute leukemia. Oral manifestations in acute leukemia as the first sign valposcholar. Oral manifestations, mainly spontaneous bleeding, are a common finding in.
Prevalence of oral lesions in and dental needs of patients with newly. The most frequently reported oral abnormalities attributed to the leukemic process include. Initial oral manifestations of leukemia sciencedirect. Oral manifestations in acute leukemia 188 the etiology of leukemia is poorly defined, most authors considering that it is multifactorial. Such patients may develop oral lesions over the course of time and have to be treated with utmost care and efficacy. This study cannot take a stand on whether local irritants cause the classic oral manifestations, as there is insufficient evidence. Oral lesions arise in both acute and chronic forms of all types of leukemia. Acute leukemia is often accompanied by oral symptoms, which are reported to be early manifestations of acute leukemia in some patients 811. Pdf leukemic oral manifestations and their management. Somayeh alirezaei, mahin bakhshi, jamilehbigom taheri, ahmad r.
The beginning of leukemia may be sudden acute or slow and gradual chronic. Acute myeloid leukaemia is often associated with early oral manifestations. What are the clinical manifestations of acute myeloid. Depending on the type, dosage and frequency of use of antineoplastic agents, severe oral complications can arise. Oral manifestations of acute myelomonocytic leukemia. Oral manifestations of leukemia abnormalities in or around the oral cavity occur in all types of leukemia and in all age groups. Oral manifestations of anemia are atrophy of the papillae on tongue, glossodynia, pallor, angular cheilitis, glossitis, aphthous ulcerserosive lesions, candidiasis, and geographic tongue. Acute myeloid leukemia is an aggressive malignant neoplasm occurring mainly in elderly, with the median age of 65 years. Oral manifestations as an early clinical sign of acute. General manifestation of leukaemia may include fatigue, anaemia. Recent findings recent studies have included a large case series examining the prevalence of ocular manifestations in newly diagnosed leukemic patients as well as case reports of ocular manifestations of leukemia. The oral manifestations of cyclic periodic neutropenia. Background the mouth buccal cavity is the reservoir for the chewing and mixing of food with saliva.
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