title: Total Extraction as a Treatment for Anaemia in a Patient of Glanzmann's Thrombasthenia with Chronic Gingival Bleed: Case Report.
abstract: Glanzmann's Thrombasthenia (GT) is a rare autosomal recessive bleeding disorder affecting the megakaryocyte lineage and is characterized by lack of platelet aggregation on stimulation. The molecular basis is linked to quantitative and qualitative abnormalities of αIIbβ3 integrin. Most of the patients with severe Glanzmann's thrombasthenia have spontaneous gum bleeding and persistent low haemoglobin levels. Often these patients are addressed with local haemostatic measures and platelet coverage. We report a case of a severe Glanzmann's thrombasthenia with chronic gingivitis and associated spontaneous gum bleed with chronic low haemoglobin levels, managed subsequently with total dental extraction under appropriate platelet and recombinant factor VIIa coverage. Further follow up of the patient substantiated the treatment protocol with increased and stable haemoglobin levels, thus emphasizing the need for total dental extraction in patients with severe Glanzmann's with chronic spontaneous gum bleed, as a definitive treatment option, which has not been reported so far in the literature.
authors.affiliation: Fellow, Head and Neck Oncology, HCG Cancer Centre , (Previously Fellow at CMC Vellore), Ahmedabad, India .
authors.forename: Abhishek
authors.initials: A
authors.lastname: Ghosh
authors.affiliation: Assistant Professor, Department of Oral and Maxillofaical Surgery, Christian Medical College and Hospital , Vellore, Tamil Nadu, India .
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Head of Department Unit I, Department of Oral and Maxillofacial Surgery, Christian Medical College and Hospital , Vellore, Tamil Nadu, India .
authors.forename: Rabin
authors.initials: R
authors.lastname: Chacko
authors.affiliation: Associate Professor, Department of Oral and Maxillofacial Surgery, Christian Medical College and Hospital , Vellore, Tamil Nadu, India .
authors.forename: Arun Paul
authors.initials: AP
authors.lastname: Charlu
keywords: Platelet disorder; Recombinant factor VIIa; Spontaneous gingival hemorrhage; Total extraction; αIIbβ3 deficiency