Management of tooth extraction in a patient with polycythemia vera and a history of multiple cerebral infarction

DOI 2 Citations 19 References
  • KIKUCHI Yoshinao
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • OMURA Susumu
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • KAWAHARA Hitomi
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • SAITO Tomokatsu
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • UMINO Satoshi
    Department of Oral and Maxillofacial Surgery, Yokohama City University Medical Center
  • FUJITA Kiyohide
    Department of Oral and Maxillofacial Surgery, Yokohama City University school of medicine

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  • 多発性脳梗塞の既往を有する真性多血症患者の多数歯抜歯経験

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Abstract

Polycythemia vera (PV) is a hematopoietic stem cell disorder that results in an increased total red cell volume. Clinically, polycythemia vera is usually diagnosed after hematologic complications, such as major thrombosis or hemorrhage. Because invasive dental treatmentfor patients with PV can cause uncontrolled hemorrhage or thrombosis, including disseminated intravascular coagulation (DIC), careful preoperative assessment and treatment planningare needed. We report a case of multiple tooth extraction in a patient with PV. A 55-year-old man with PV was referred to our clinic because of abnormal bleeding after periodontal scaling. He had a history of multiple cerebral infarction and hypertension, and had beenreceiving an oral antithrombotic drug. Since the patient complained of difficulty in eating due to gingival bleeding associated with severe periodontitis, tooth extraction was planned. The blood condition was controlled by the patient's physician and multiple tooth extraction was performed without stopping the oral antithrombotic drug. Although hemorrhage fromthe socket recurred for several days, complete hemostasis was achieved 10 days after surgery by the use of a hemostatic splint.

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