PERIODONTAL MICROBIOLOGIC PROFILE OF PATIENTS WITH AMEGAKARYOCYTIC PURPURA POST BONE MARROW TRANSPLANTATION

Two siblings (2 and 4 years old) diagnosed with amegakaryocytic purpura after hematopoietic stem cell transplantation were diagnosed with graft vs host disease (GVHD) in the skin, buccal and gastrointestinal mucosa and lungs. Dental biofilm accumulation and periodontal clinical attachment loss (PCAL) were also observed in the dental evaluation. Samples of dental biofilm were collected for analysis using the Checkerboard DNA-DNA hybridization technique to determine the microbiologic profile. The hypothesis was that PCAL could be associated with the microbial profile compatible with periodontal disease and, therefore, a local treatment would be effective. However, the samples showed normal cell counts of bacterial species compatible with health and low counts of species compatible with the disease (higher in the patient with older age than in younger). We conclude that the observed PCAL was more compatible with a local manifestation of GVHD than with a change in the microbiologic profile.