Pseudopathologies of hemostasis and dental surgery.
Values of hemostasis tests are grossly abnormal in persons with factor XII deficiency, dysfibrinogenemia, the lupuslike anticoagulant, and pseudothrombocytopenia, yet these persons do not usually bleed spontaneously or even after surgery. We reviewed the records of 66 patients with laboratory diagnosis of one of the aforementioned abnormalities to determine whether they bled excessively after challenges to hemostasis such as dental extractions. Only three of them bled excessively, but two of these had other concomitant causes that could explain bleeding. Hence the dentist should not give up dental extractions or other surgical procedures when results of hemostasis tests are grossly abnormal, because these are not necessarily associated with abnormal hemostasis. Obviously, the correct interpretation of abnormal hemostasis values warrants close collaboration and reciprocal consultation between the dentist and the hematologist.
Capitanio
A M
AM
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, University of Milan, Italy.
Sacco
R
R
Mannucci
P M
PM
D000328:Adult; D001778:Blood Coagulation Disorders / Q000175:diagnosis / Q000503:physiopathology*; D001779:Blood Coagulation Factors / Q000032:analysis / Q000276:immunology; D001780:Blood Coagulation Tests; D016063:Blood Loss, Surgical; D003730:Dental Care for Persons with Disabilities; D005260:Female; D006801:Humans; D016682:Lupus Coagulation Inhibitor; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D014081:Tooth Extraction / Q000009:adverse effects*
D001779:Blood Coagulation Factors; D016682:Lupus Coagulation Inhibitor