title: Excessive gingival bleeding in two patients with Glanzmann thrombasthenia.
abstract: BACKGROUND
  Glanzmann thrombasthenia (GT) is an exceedingly rare but well-defined inherited disorder of platelet function caused by a defect in the glycoprotein IIb/IIIa complex. The association of GT with consanguinity has been noted, especially in geographic regions in which intermarriage is common. In most patients, GT is diagnosed during early infancy or before the age of 5 years. Common manifestations of this disorder are gingival hemorrhage, purpura, epistaxis, petechiae, and menorrhagia. Chronic, prolonged, untreated, or unsuccessfully treated bleeding may be life threatening.
  
  
  METHODS
  We report two female patients with GT who were referred by our hematology clinic to our periodontology department for the treatment of excessive gingival bleeding. The first patient was treated with a platelet transfusion and underwent periodontal therapy (scaling and root planing and dental polishing). The second patient, whose GT was undiagnosed at the time of her referral to our department, applied to our emergency service because of uncontrolled gingival bleeding that developed after scaling and root planing was performed by her dentist. Both patients had been called for regular dental visits.
  
  
  RESULTS
  All treated sites healed without complications. The first patient was monitored for 2 years, during which she practiced proper oral hygiene and experienced no periodontal complications. The other patient did not participate in follow-up.
  
  
  CONCLUSIONS
  Gingival bleeding is usually the first sign of most hematologic disorders, and dentists must be alert for the signs of unusual gingival bleeding. In such cases, collaboration with a hematologist is essential. Under the proper circumstances, periodontal treatment can be performed with an acceptable outcome. With proper oral hygiene, we believe that there will be no complications and no gingival bleeding.
authors.affiliation: Department of Periodontology, Faculty of Dentistry, Baskent University, Ankara, Turkey. usluhilaladana@yahoo.com
authors.forename: Hilal Uslu
authors.initials: HU
authors.lastname: Toygar
authors.forename: Esra
authors.initials: E
authors.lastname: Guzeldemir
mesh_terms: D000328:Adult; D002648:Child; D003241:Consanguinity; D017742:Dental Care for Chronically Ill / Q000379:methods*; D012534:Dental Scaling / Q000009:adverse effects; D005260:Female; D005881:Gingiva; D005884:Gingival Hemorrhage / Q000209:etiology* / Q000628:therapy; D006801:Humans; D009910:Oral Hygiene / Q000379:methods; D017713:Platelet Transfusion; D016745:Root Planing / Q000009:adverse effects; D013915:Thrombasthenia / Q000150:complications*