EXUBERANT GINGIVAL NECROSIS IN A POST-TRANSPLANT PATIENT

Abstract

A 20-year-old male patient diagnosed with non-Hodgkin's lymphoma in 2017 and Fanconi anemia in 2019 underwent hematopoietic stem cell transplantation (HSCT) in January 2021. The case evolved with a generalized exuberant periodontal necrosis, painful symptomatology without clear cause, presenting significant thrombocytopenia and neutropenia. Initially, the lesions showed an ischemic aspect in the buccal and palatal/lingual gingival area with subsequent darkening, which culminated in detachment and loss of underlying bone tissue. Complementary tests to rule out infectious hypotheses were inconclusive and histopathologic analysis showed only tissue necrosis, and the condition was associated with post-HSCT pancytopenia. The atypical clinical manifestation presented by the patient does not present a specific etiology/pathogenesis clarified in the literature, and interventions at that time were not indicated, due to both the patient's general condition and the presentation of the lesions. The patient remains in follow-up with the dental team, showing good evolution of the oral condition. A 20-year-old male patient diagnosed with non-Hodgkin's lymphoma in 2017 and Fanconi anemia in 2019 underwent hematopoietic stem cell transplantation (HSCT) in January 2021. The case evolved with a generalized exuberant periodontal necrosis, painful symptomatology without clear cause, presenting significant thrombocytopenia and neutropenia. Initially, the lesions showed an ischemic aspect in the buccal and palatal/lingual gingival area with subsequent darkening, which culminated in detachment and loss of underlying bone tissue. Complementary tests to rule out infectious hypotheses were inconclusive and histopathologic analysis showed only tissue necrosis, and the condition was associated with post-HSCT pancytopenia. The atypical clinical manifestation presented by the patient does not present a specific etiology/pathogenesis clarified in the literature, and interventions at that time were not indicated, due to both the patient's general condition and the presentation of the lesions. The patient remains in follow-up with the dental team, showing good evolution of the oral condition.