Dental management in patient with amyloidosis underwent to autologous hematopoietic stem cell transplantation – Case report

Abstract

Amyloidosis is characterized by extracellular deposition of a fibrillary pathological or insoluble protein in organs

and tissues, and it can be classified as primary or secondary. Case Report: A male 62 years old patient presented

complaint of back pain followed by macroglossia. The biopsy of the tongue confirmed the amyloidosis diagnosis.

The treatment was autologous transplant of hematopoietic stem cells. The intraoral physical examination during the transplant period showed macroglossia, dehydrated lips and mucosa with no ulcerated lesions in all the oral mucosa and submandibular lymph node. A protocol for oral hygiene was instituted based on the use of 12,000 bristles brush and chlorhexidine-base toothpaste to 0.12% chlorhexidine rinses 0.12%, HPA-Lanolin to hydrate the kips and moisturizing gel for the oral mucosa followed by low power lasertherapy for the oral mucositis daily from D0 to D+11. The Visual Analogical Scale was used to quantify the tongue and oropharyngeal pain/discomfort score. The patient described a score in the tongue before the lasertherapy (0-6 range) and after the lasertherapy (0-3 range). The patient reached the highest score of oral mucositis (L1 - WHO). Conclusions: The diagnosis of amyloidosis with oral manifestations and applying the oral hygiene protocol to prevent the oral mucositis along transplant were effective in controlling and reducing oral during the transplant, and such application is recommended.