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Gingival and lip hypertrophy induced by cyclosporin a treatment in an aplastic anemia patient/Aplastik anemili bir hastada siklosporin a tedavisi ile induklenen gingiva ve dudak hipertrofisi.

Cyclosporin A (CsA)-induced gingival overgrowth is one of the major side effects affecting the quality of life of patients under immunosuppressive therapy, but lip enlargement is less frequently recognized. CsA affects T lymphocytes, which play a pivotal role in the periodontal antibacterial immune response.

The authors present a case of marked gingival hypertrophy associated with lip hypertrophy (Image 1) in a 19-year-old man with severe aplastic anemia treated with CsA. The daily dose of CsA was 4 mg/kg body weight. CsA improved the clinical and hematological signs of aplastic anemia.

The development of this adverse effect appeared three months after beginning the immunosuppressive treatment with CsA [1].

The patient received a 14-day course of metronidazole, 500 mg three times daily. One month after the end of this therapy, the grade of gingival hypertrophy (according to the grading method of Matarasso) had improved from grade 3 to grade 1, and the lip hypertrophy had disappeared. Over the next one month, the condition remitted completely and had not recurred.

This rare and less understood adverse effect should be recognized during the clinical evaluation of CsA treatment.



[1.] Lip hypertrophy secondary to cyclosporin treatment. Cansick JC, Hulton SA. Pediatr Nephrol. 2003 Jul;18:710-1.

Illias Tazi

Hematology and Pediatric Oncology Department, Hospital, Casablanca, Morocco

Address for Correspondence: Illias Tazi, Hematology and Pediatric Oncology Department, Hospital, 20 Aout 1953, Casablanca, Morocco E-mail:
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Title Annotation:Images in Hematology
Author:Tazi, Illias
Publication:Turkish Journal of Hematology
Article Type:Brief article
Geographic Code:6MORO
Date:Jun 1, 2009
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