Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports
Abstract Background Uncontrollable bleeding after tooth extraction usually occurs in patients with coagulation diseases, including hemophilia, von Willebrand’s disease, vitamin K deficiency, platelet deficiency, and taking anticoagulant drugs. Hemophilia A is an X-linked recessive disorder caused by...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Oral Health |
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| Online Access: | https://doi.org/10.1186/s12903-022-02074-9 |
| _version_ | 1818315599679324160 |
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| author | Guo Fan Yi Shen Yu Cai Ji-hong Zhao Yang Wu |
| author_facet | Guo Fan Yi Shen Yu Cai Ji-hong Zhao Yang Wu |
| author_sort | Guo Fan |
| collection | DOAJ |
| description | Abstract Background Uncontrollable bleeding after tooth extraction usually occurs in patients with coagulation diseases, including hemophilia, von Willebrand’s disease, vitamin K deficiency, platelet deficiency, and taking anticoagulant drugs. Hemophilia A is an X-linked recessive disorder caused by insufficiency of coagulation factor VIII. Mild hemophilia, defined by factor level between 0.05 and 0.40 IU/mL, is characterized by uncontrollable hemorrhage after trauma or invasive operations. Some mild hemophiliacs may remain undiagnosed until late adulthood. Therefore, surgical management of these patients may be relatively neglected. These case reports describe two uncontrollable bleeding patients with unknown mild hemophilia A after tooth extraction. Case presentation This paper reports 2 cases of persistent bleeding after tooth extraction under local anesthesia which could not be completely stopped by routine treatments. Both of them denied prior illness and injury, allergies, anticoagulant medication history, systemic and family illness. The APTT and other coagulation screening tests of the two patients before surgery were normal. Finally, they were diagnosed with mild hemophilia A via coagulation factor assays. The patients acquired complete hemostasis by receiving coagulation factor supplement therapy in hematologic department. Conclusion Mild hemophilia is marked by subclinical, asymptomatic and even normal coagulation test results. The purpose of these case reports is to bring dental professionals’ attention that APTT test alone cannot be used to exclude mild hemophilia, and provide reasonable evaluation and treatment procedures of bleeding patients after tooth extraction. |
| first_indexed | 2024-12-13T09:08:06Z |
| format | Article |
| id | doaj.art-5381e7e7e50845959c3085cfdc3e36ef |
| institution | Directory Open Access Journal |
| issn | 1472-6831 |
| language | English |
| last_indexed | 2024-12-13T09:08:06Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Oral Health |
| spelling | doaj.art-5381e7e7e50845959c3085cfdc3e36ef2022-12-21T23:53:01ZengBMCBMC Oral Health1472-68312022-03-012211810.1186/s12903-022-02074-9Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reportsGuo Fan0Yi Shen1Yu Cai2Ji-hong Zhao3Yang Wu4The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityThe State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityThe State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityThe State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityThe State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan UniversityAbstract Background Uncontrollable bleeding after tooth extraction usually occurs in patients with coagulation diseases, including hemophilia, von Willebrand’s disease, vitamin K deficiency, platelet deficiency, and taking anticoagulant drugs. Hemophilia A is an X-linked recessive disorder caused by insufficiency of coagulation factor VIII. Mild hemophilia, defined by factor level between 0.05 and 0.40 IU/mL, is characterized by uncontrollable hemorrhage after trauma or invasive operations. Some mild hemophiliacs may remain undiagnosed until late adulthood. Therefore, surgical management of these patients may be relatively neglected. These case reports describe two uncontrollable bleeding patients with unknown mild hemophilia A after tooth extraction. Case presentation This paper reports 2 cases of persistent bleeding after tooth extraction under local anesthesia which could not be completely stopped by routine treatments. Both of them denied prior illness and injury, allergies, anticoagulant medication history, systemic and family illness. The APTT and other coagulation screening tests of the two patients before surgery were normal. Finally, they were diagnosed with mild hemophilia A via coagulation factor assays. The patients acquired complete hemostasis by receiving coagulation factor supplement therapy in hematologic department. Conclusion Mild hemophilia is marked by subclinical, asymptomatic and even normal coagulation test results. The purpose of these case reports is to bring dental professionals’ attention that APTT test alone cannot be used to exclude mild hemophilia, and provide reasonable evaluation and treatment procedures of bleeding patients after tooth extraction.https://doi.org/10.1186/s12903-022-02074-9APTTMild hemophilia APersistent bleedingTooth extractionCase reports |
| spellingShingle | Guo Fan Yi Shen Yu Cai Ji-hong Zhao Yang Wu Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports BMC Oral Health APTT Mild hemophilia A Persistent bleeding Tooth extraction Case reports |
| title | Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports |
| title_full | Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports |
| title_fullStr | Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports |
| title_full_unstemmed | Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports |
| title_short | Uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients: two case reports |
| title_sort | uncontrollable bleeding after tooth extraction from asymptomatic mild hemophilia patients two case reports |
| topic | APTT Mild hemophilia A Persistent bleeding Tooth extraction Case reports |
| url | https://doi.org/10.1186/s12903-022-02074-9 |
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