title: Necrotizing gingivitis: a possible oral manifestation of ticlopidine-induced agranulocytosis.
abstract: Agranulocytosis is a rare complication of ticlopidine and can be life-threatening. We report a case of ticlopidine-induced agranulocytosis and neutropenia (neutrophil count of 0.1 x 10(9)/L) with necrotizing gingivitis in a 54-year-old Malaysian-Chinese female. She was started on ticlopidine 250 mg twice daily 3 weeks prior to this hospital admission. We started her on intravenous metronidazole and amoxicillin and clavulanic acid (Augmentin) and concurrently stopped ticlopidine. A series of clinical and laboratory investigations were carried out and a final diagnosis of necrotizing gingivitis possibly secondary to agranulocytosis was made. The patient was discharged home after 2 weeks of hospitalisation.
authors.affiliation: Oral & Maxillofacial Surgery, Hospital Universiti Kebangsaan, Kuala Lumpur, Malaysia.
authors.forename: Rama Krsna
authors.initials: RK
authors.lastname: Rajandram
authors.forename: Roszalina
authors.initials: R
authors.lastname: Ramli
authors.forename: Fadzlina
authors.initials: F
authors.lastname: Karim
authors.forename: Roslan Abdul
authors.initials: RA
authors.lastname: Rahman
authors.forename: Leong Chooi
authors.initials: LC
authors.lastname: Fun
mesh_terms: D000380:Agranulocytosis / Q000139:chemically induced* / Q000175:diagnosis*; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005892:Gingivitis, Necrotizing Ulcerative / Q000175:diagnosis*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy; D007150:Immunohistochemistry; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology; D013988:Ticlopidine / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D013988:Ticlopidine