Oral presentation of haematological disease : Part I – Diseases of bone marrow failure

Abstract

INTRODUCTION : The bone marrow is responsible for haemopoiesis, but when it fails, oral mucosal lesions may be seen due to reduced platelets, white blood cells, or red blood cells. AIMS AND OBJECTIVES : This study aims to report on three patients who presented with leukaemia, aplastic anaemia and neutropenia, respectively, with spontaneous bleeding, ulceration and mucosal pallor. DESIGN/METHODS : The oral mucosal features of three patients who presented at the University of Pretoria Oral Health Centre, with varying degrees of bone marrow failure, were recorded. Special investigations were performed to check their bone marrow function. The patients were managed collaboratively with their respective physicians. RESULTS: These cases demonstrate that dentists should be cognisant of disorders of bone marrow failure so that patients are a) diagnosed timely and appropriately, b) referred back to their treating clinician due to relapse of a known disease, or c) managed in collaboration with their treating clinician to confirm a suspected diagnosis. CONCLUSIONS : Dentists play a pivotal role in diagnosing haematological disease that results from bone marrow failure. Bleeding, ulceration and mucosal pallor are important diagnostic indicators of reduced platelet, neutrophil and red blood cell counts.