Dental extraction in congenital factor Vll deficiency with inhibitor – a case report

G. Nayar, V. Pillai, S. Mathew, G. Menon
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Abstract

Abstract Background Hereditary factor VII (FVII) deficiency is a rare bleeding disorder with autosomal recessive inheritance, and FVII deficiency with an inhibitor is extremely rare. There is sparse information in the literature on the management of tooth extraction in patients with FVII deficiency and an inhibitor. Case description We report the case of a five-year-old child with FVII deficiency and an inhibitor who underwent dental extraction. The child had had multiple bleeding episodes including intracranial haemorrhage and had a history of severe allergic reaction to the infusion of recombinant FVII. The tooth was extracted using lignocaine gel and the antifibrinolytic agent oral tranexamic acid. Conclusion The extraction of a deciduous tooth in a patient with FVII deficiency and an inhibitor was undertaken without bleeding complications. There are currently no guidelines regarding management of this type of case. Further studies and evidence are required so that management can be standardised.
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先天性Vll因子缺乏伴抑制剂拔牙1例
遗传因子七(FVII)缺乏症是一种罕见的常染色体隐性遗传出血性疾病,FVII缺乏症伴抑制剂极为罕见。文献中关于FVII缺乏和抑制剂患者拔牙的管理信息很少。病例描述我们报告一例五岁的儿童与FVII缺乏和抑制剂谁接受拔牙。该患儿曾多次出血,包括颅内出血,并对重组FVII输注有严重过敏反应史。采用利多卡因凝胶和抗纤溶剂口服氨甲环酸进行拔牙。结论1例FVII缺乏伴抑制剂的乳牙拔除无出血并发症。目前没有关于这类病例管理的指导方针。需要进一步的研究和证据,以便使管理标准化。
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