{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:59:08Z","timestamp":1747187948629,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T00:00:00Z","timestamp":1720656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Special Care in Dentistry"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary Immune Thrombocytopenic Purpura (ITP) is an autoimmune hematological condition characterized by isolated thrombocytopenia and frequently presents with oral manifestations. However, reports of primary ITP in patients with Turner Syndrome (TS) are exceptionally rare, with few cases documented in the literature. Herein, we describe an unusual case of primary ITP with exuberant oral manifestations in a patient with TS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 29\u2010year\u2010old woman was referred to an oral diagnostic service with complaints of \u201cblood blisters and gum bleeding\u201d lasting 8\u00a0h. On extraoral physical examination, multiple petechiae were observed in the upper and lower limbs, in addition to hemorrhagic extravasation in the right ocular sclera (hyposphagma). On intraoral examination, multiple vesicles and blisters filled with blood were identified on the lower lip, back of the tongue, and buccal mucosa, along with spontaneous gingival bleeding and hemorrhagic petechiae on the palate. Laboratory tests revealed thrombocytopenia (5000\/mm<jats:sup>3<\/jats:sup>), whereas the blood count showed normality in the red and white series. After excluding other etiological factors or associated diseases, the patient was diagnosed with severe ITP and began treatment with systemic corticosteroids in the intensive care unit, resulting in a successful increase in platelets. After a 2\u2010year follow\u2010up, the patient remains free of ITP recurrences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Oral manifestations may be one of the first signs of ITP. Therefore, it is essential that dentists are familiar with the condition and, when faced with unusual oral bleeding, consider the possibility of a hematological disorder such as ITP, ensuring a correct and early diagnosis. Moreover, the presence of ITP can further exacerbate complications associated with TS. Therefore, rigorous follow\u2010up of these patients is crucial, considering the high incidence of cardiovascular and autoimmune diseases and the reduced life expectancy of these patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/scd.13039","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T04:14:50Z","timestamp":1720757690000},"page":"1564-1571","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Primary immune thrombocytopenic purpura with exuberant oral manifestations in a patient with Turner syndrome"],"prefix":"10.1111","volume":"44","author":[{"given":"Liz Oliveira Trajano dos","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Dentistry University Center of Patos (UNIFIP)  Campina Grande Para\u00edba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ang\u00e9lica de Sousa","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Dentistry University Center of Patos (UNIFIP)  Campina Grande Para\u00edba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3895-7947","authenticated-orcid":false,"given":"Marielly de Souza","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Center for Biological and Health Sciences Federal University of Western Bahia (UFOB)  Barreiras Bahia Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2834-5049","authenticated-orcid":false,"given":"Natalia Vit\u00f3ria de Ara\u00fajo","family":"Lopes","sequence":"additional","affiliation":[{"name":"Department of Dentistry State University of Para\u00edba (UEPB)  Campina Grande Para\u00edba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Klidenberg","family":"de Oliveira J\u00fanior","sequence":"additional","affiliation":[{"name":"Department of Dentistry University Center of Santa Maria (UNIFSM)  Cajazeiras Para\u00edba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5591-5801","authenticated-orcid":false,"given":"Hianne Cristinne de Morais","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Department of Dentistry University Center of Patos (UNIFIP)  Campina Grande Para\u00edba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0679-8485","authenticated-orcid":false,"given":"John Lennon Silva","family":"Cunha","sequence":"additional","affiliation":[{"name":"Center for Biological and Health Sciences Federal University of Western Bahia (UFOB)  Barreiras Bahia Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9657-5180","authenticated-orcid":false,"given":"Luan \u00c9verton Galdino","family":"Barnab\u00e9","sequence":"additional","affiliation":[{"name":"Department of Dentistry University Center of Patos (UNIFIP)  Campina Grande Para\u00edba Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.49313"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2478\/rjim\u20102019\u20100014"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/dj9090108"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0b013e3282ab98f2"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201006\u2010225565"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V88.1.3.3"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102008\u201007\u2010162503"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1210\/endo-23-5-566"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100043\u20101770982"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2018.00307"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1096\u20108628(19971112)72:4"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102591.2005.01023.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2009.10.008"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1067\/mod.2001.115719"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/1824\u20107288\u201039\u201079"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v90i3.8737"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00511"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102249.2009.03895.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/ped.13944"},{"issue":"1","key":"e_1_2_7_21_1","first-page":"118","article-title":"[Turner's syndrome complicated by idiopathic thrombocytopenic purpura]","volume":"28","author":"Sugaya N","year":"1987","journal-title":"Rinsho Ketsueki"},{"key":"e_1_2_7_22_1","first-page":"899","volume-title":"[A case of Turner's syndrome with idiopathic thrombocytopenic purpura, and Hashimoto's thyroiditis detected in the course of ulcerative colitis]","author":"Obata S","year":"1994"},{"key":"e_1_2_7_23_1","first-page":"180","article-title":"A case of Turner's syndrome complicated with ITP during GH therapy. (abstract)","volume":"15","author":"Iwata M","year":"1997","journal-title":"Pharma Medica"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27270"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011501"},{"issue":"2","key":"e_1_2_7_26_1","first-page":"159","article-title":"Immune thrombocytopenic purpura detected with oral hemorrhage: a case report","volume":"19","author":"Sugiura T","year":"2018","journal-title":"J Dent"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/hematolrep16020021"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sdentj.2017.08.004"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.4317\/medoral.24870"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.15644\/asc52\/4\/10"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.V77.1.31.31"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12813"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277\u2010022\u201004784\u20100"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOH.0000000000000270"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1055\/s\u20100034\u20101544001"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102009\u201007\u2010229815"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102012\u201009\u2010455691"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(15)00114\u20103"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2352\u20103026(21)00030\u20102"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102017\u201009\u2010742353"}],"container-title":["Special Care in Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/scd.13039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T13:45:21Z","timestamp":1731505521000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/scd.13039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,11]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/scd.13039"],"URL":"https:\/\/doi.org\/10.1111\/scd.13039","archive":["Portico"],"relation":{},"ISSN":["0275-1879","1754-4505"],"issn-type":[{"type":"print","value":"0275-1879"},{"type":"electronic","value":"1754-4505"}],"subject":[],"published":{"date-parts":[[2024,7,11]]},"assertion":[{"value":"2024-05-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}