A 55-year-old man was referred to us because of renal dysfunction (serum creatinine 1.82 mg/dL). Three years earlier, he had aortic dissection associated with left renal artery occlusion and had undergone surgery for ascending aorta and aortic arch replacement. He had been receiving the following medications for 3 years; nifedipine (Adalat-CR) 40 mg, carvedilol 10 mg, aspirin 100 mg, allopurinol 200 mg, and famotidine 10 mg daily. Examination revealed severe gingival hypertrophy with bleeding (Picture 1).
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