JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 54 No. 1                     2008

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

We report a case of mucous membrane pemphigoid (MMP) limited to the oral mucosa that was associated with myelodysplastic syndrome (MDS). A 72-year-old man had gingival erosion and tenderness for 3 months. He was referred to our hospital on January 15, 2000 because the lesions did not improve. Physical and nutritional status was good. No abnormalities were noted on the skin. Gingival redness and tenderness were present throughout the oral cavity. Gingival erosion had developed in the maxillary anterior tooth and left mandibular molar regions. Laboratory examinations showed a high IgG level, but no other abnormalities were detected. Direct immunofluorescence studies showed linear deposits of IgG and C3 in the basal membrane region. Indirect immunofluorescence studies using 1 M NaC1 split skin showed linear IgG on the epidermal side. Immunoblotting revealed autoantibodies to the C-terminal domain of BP18O. Therefore, the patient was given a diagnosis of MMP. Daily treatment with 900 mg nicotinamide and 900 mg erythromycin slightly improved the oral condition. However, nasal and oral hemorrhage started in May 2000. Platelets markedly decreased to 1000/1. The patient was given a diagnosis of MDS on the basis of chromosomal tests. To our knowledge, MMP is very rarely associated with MDS. Keywords: mucous membrane pemphigoid, myelodysplastic syndrome, thrombocytopenia.

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