Idiopathic Gingival Hyperplasia: Clinical Features and Differential Diagnosis

摘要

Case presentation A 32-year-old man was referred to the oral diagnosis and radiology department of a university dental faculty for investigation of gingival bleeding. His medical history was unremarkable, and he had not been taking any medications. Intraoral examination revealed marked gingival hyperplasia (Fig. 1). The results of a complete blood count indicated no significant abnormalities, with only slight decreases in red blood cells, hemoglobin and hematocrit and a slight elevation of lymphocytes. For further analysis and confirmation of these results, another complete blood count was performed 2 days later, at which time levels of free thyroxine (T_4) and thyroid-stimulating hormone (TSH) were also determined. The patient's T_4 level was low, whereas his TSH was elevated. Levels of antibodies to thyroid peroxidase (titre 1049) and thyro-globulin (titre 1075) were highly elevated. Ultrasonography revealed that both lobes of the thyroid gland were smaller than normal, with lobulated contours. The echotexture was pseudonodular. Thickening of the hair and excessive hairiness of the face were detected during an extraoral examination, and the patient stated that he had gained weight. Desquamation of the patient's back was evident. Incisional biopsy of the gin-giva, followed by histopathologic examination, was performed.