THE CLINICAL EXPRESSION OF THROMBOCYTOPENIA AND THE HEALTH IMPACT OF THE ORAL CAVITY

Thrombocytopenia represents one of the most frequent causes of addressability for a hematological consultation. The purpose of the study is to establish a correlation between the degree of thrombocytopenia and the appearance of the mucocutaneous bleeding, with a therapeutic purpose. Materials and method: Our study is a retrospective observational study and was carried out on a group of 100 patients who were referred to the Hematology Clinic of Sp. St. Spiridon, Iași for a period of 12 months and who presented with isolated thrombocytopenia on admission. Other coagulopathy evolving with thrombocytopenia were excluded. To establish the correlation between the decrease in the number of platelets and the appearance of the hemorrhagic skin-mucosal syndrome, statistical methods were used – F Test – Two sample for Variance. Results and discussions: Thrombocytopenia was defined as the value of platelets below 150,000\mmc. 5 grades of thrombocytopenia were established: grade I (TR=150,000-100,000/mmc), grade II (TR= 100,000-50,000/mmc), grade III (TR=50,000-20,000/mmc), grade IV (TR= 20,000 -10,000/mmc), grade V (TR below 10,000/mmc)40% of the patients included in the study presented thrombocytopenia gr. I, 24% – grade II, 15% – grade III, 6% – grade IV and 15% presented severe thrombocytopenia (grade V). The mucocutaneous bleeding was manifested by: petechiae and ecchymosis, epistaxis, bleeding in the oral cavity (gingival bleeding, hemorrhagic bullae), menometrorrhagia, hematuria, melena. There is a statistical correlation between the number of platelets and the occurrence of mucocutaneous bleeding: p=0.000121 (p less than 0.001). The first clinical manifestations of the mucocutaneous bleeding appeared at the value of 70,000/mmc. No statistical correlation was obtained between the age of the patients and the number of platelets (p=0.0352). Conclusions: The occurrence of mucocutaneous bleeding is directly related to the decrease in the number of platelets. The oral cavity usually is involved in bleeding caused by the decrease in the number of platelets and requires a multidisciplinary approach.