歯肉出血を契機に発見された先天性第X因子欠乏症の1例

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  • A case of congenital factor X deficiency diagnosed incidentally due to gingival bleeding
  • シニク シュッケツ オ ケイキ ニ ハッケン サレタ センテンセイ ダイ Ⅹ インシ ケツボウショウ ノ 1レイ

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Congenital factor X deficiency is a rare autosomal, recessive inherited bleeding disorder, with an incidence of 1 per 500,000 individuals. We diagnosed congenital factor X deficiency disease in a patient with persistent gingival bleeding before tooth extraction. The patient was a 47-year-old man who repeatedly had gingival bleeding after dental scaling. The medical history included excessive epistaxis when he was an infant and difficulty in hemostasis after tooth extraction. The details of his family history were unknown, except that his younger brother also appeared to have a bleeding problem. Intraoral examination showed persistent bleeding from the right, upper second molar, buccal gingival crevice and tooth mobility. A blood test showed a prolonged prothrombin time and activated partial thromboplastin time, which required appropriate consultation and careful examination. Factor X activity was found to be low (2.2%) and a definitive diagnosis of congenital factor X deficiency was made. Because of subsequent repeated gingival bleeding, severe marginal periodontitis in the region of the right upper second molar and periapical periodontitis in the region of the right lower first molar were diagnosed, and the teeth were extracted. Tooth extraction was performed after transfusion of fresh frozen plasma. The wound was filled with oxidized cellulose and sutured. Congenital factor X deficiency was diagnosed and treated in this patient with persistent gingival bleeding before tooth extraction.

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