Τίτλος:
Gingival Ischemia and Petechiae in a Patient Medicated With PCSK9 Inhibitor for Hypercholesterolemia: An Adverse Drug Event?
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
INTRODUCTION: Monoclonal antibodies against proprotein-convertase subtilisin/kexin type 9 (PCSK9) inhibitors are a newly-introduced therapeutic approach against hypercholesterolemia. Clinical trials have reported few adverse effects of PCSK9 inhibitors and there are no reports of oral adverse effects. We present the case of a patient that showed gingival discomfort on eating and toothbrushing, coupled with the presence of gingival ischemia and petechiae, 3 days after a subcutaneous abdominal injection of 75-mg alirocumab for hypercholesterolemia, and contemplate on their possible pathogenesis. CASE PRESENTATION: Αn 81-year-old male presented with gingival discomfort during eating and toothbrushing, 3 days after receiving a subcutaneous abdominal injection of alirocumab. Intraoral examination revealed that the anterior free and attached gingiva of both jaws appeared pale and the surrounding mucosa showed confluent petechiae that were more evident on the anterior palatal gingiva. The patient was asked to brush his teeth with a soft toothbrush and use a mouthwash containing hydrogen peroxide three times daily. At the 8-day re-examination he was symptom-free, and the mucosa appeared totally normal. At the 5-month follow-up visit he reported having the same symptoms after each one of the 12 doses of alirocumab he received. CONCLUSIONS: Adverse dugs effects associated with subcutaneous injection of alirocumab may manifest in the gingiva. Therefore, oral and periodontal examination should be included in the regular follow-up of patients medicated with this drug. © 2018 American Academy of Periodontology.
Συγγραφείς:
Thermos, G.
Tosios, K.I.
Περιοδικό:
Clinical Advances in Periodontics
Λέξεις-κλειδιά:
alirocumab; monoclonal antibody; PCSK9 protein, human; proprotein convertase 9, case report; diagnostic imaging; gingiva; human; hypercholesterolemia; ischemia; male; purpura; very elderly, Aged, 80 and over; Antibodies, Monoclonal, Humanized; Gingiva; Humans; Hypercholesterolemia; Ischemia; Male; Proprotein Convertase 9; Purpura
