Objectives: To describe in details the clinical prsentation and management of a young adult who presented with autoimmune thrombocytopenic purpura in the oral cavity.
Method: A case report of a young lady who was referred to our clnic with severe gum bleeding and petechiae by her physician. Examination revealed multiple haemorrhagic spots on the gingivae as well as buccal mucosa and palate. Conjunctival examination showed moderate pallor.
A differential diagnosis of acute gingivitis with or kaposis sarcoma as well as anaemia was made. Consequently an investigation of full haemogram and ELISA was ordered.
Results: Full haemogram revelaed a platelet count of 4x109/L while haemoglobin level was 4.8g/L. Elisa for HIV assay was positive. Further investigation on bone marow confirmed megakarocytopoiesis consistent with peripheral consumption or destruction of platelets. Patient was admitted; Blood transfusion done (1pint given): she was then started on oral prednisolone at a dose of 50mg daily (1mg/Kg/day) and satisfactory response obtained within a few days. The dose was gradually reduced. She was discharged 10 days later with platelet count of 150x109/L.
Conclusions: Autoimmune thrombocytopenic purpura though rare can present with a confusing picture in the oral cavity and needs to be distinguished from kaposis sarcoma and gingivitis. Steroids remain the mainstay of its therapy.