Akademik Veri Yönetim Sistemi
21st International Hippocrates Congress on Medical and Health Sciences, İstanbul, Türkiye, 13 - 14 Mart 2026, ss.76-77, (Özet Bildiri)
Surgical
Management of Cyclosporine-Associated Gingival Hyperplasia in Patients with
Idiopathic Thrombocytopenic Purpura: A Case Report
Abstract
Background:
Drug-induced gingival hyperplasia is a significant adverse effect of systemic
medications such as cyclosporine, phenytoin, and calcium channel blockers on
periodontal tissues. Cyclosporine, commonly used for its immunosuppressive
properties, may induce gingival enlargement by increasing fibroblast activity.
This study aimed to evaluate the periodontal and surgical management of
cyclosporine-induced gingival hyperplasia in the presence of concomitant
Idiopathic Thrombocytopenic Purpura (ITP) and to emphasize the importance of a
multidisciplinary approach in patients with a high risk of bleeding.
Case
Presentation: A 47-year-old female patient presented with complaints of
gingival swelling, bleeding, and pain. Her medical history revealed aplastic
anemia and ITP. She had been taking cyclosporine (100 mg twice daily) and
eltrombopag (50 mg three times daily) for approximately 1.5 years. Clinical
examination demonstrated generalized fibrotic gingival hyperplasia affecting
mastication, bleeding on probing, and localized suppuration. Oral hygiene
instructions and Phase I periodontal therapy were performed. Due to the
likelihood of cyclosporine-induced gingival enlargement, a consultation with
the relevant physician was conducted; however, modification of the medication
regimen was not considered appropriate. Prior to surgery, a hematology
consultation was obtained to increase the platelet count to ≥100,000/mm³.
Platelet replacement therapy was administered before both surgical sessions,
and 2 g of oral amoxicillin was given as prophylaxis 30–60 minutes prior to the
procedures. Gingivectomy and gingivoplasty were performed in the maxillary and
mandibular arches at two-week intervals, with platelet transfusion administered
one day before each surgery. Postoperatively, analgesics and antiseptic
mouthwash were prescribed as supportive therapy.
Results:
Although initial periodontal therapy resulted in a reduction of inflammation,
surgical excision was required due to the extent of the gingival enlargement.
The surgical procedures were completed under safe hematological conditions.
Postoperative healing was uneventful, and functional as well as esthetic
gingival contours were successfully restored.
Conclusion:
This case demonstrates that cyclosporine-induced gingival hyperplasia can be
safely and effectively managed with a multidisciplinary approach,
even in the presence of ITP. Preoperative platelet optimization enhanced
surgical safety and resulted in satisfactory clinical outcomes. Regular
periodontal follow-up is essential to minimize the risk of recurrence.
Keywords:
Gingival Hyperplasia, Cyclosporine, Thrombocytopenia