Cyclosporin-A-induced gingival enlargement. A case report.

Cyclosporin-A (CsA)-induced gingival enlargement has been reported in a small number of cases but may involve up to one third of all patients taking CsA. The present study reports a case of CsA-induced gingival enlargement during suppressive therapy for myasthenia gravis. Gingival tissues were examined histologically, histochemically, and immunohistologically. The basic tissue response seemed to be a dental plaque- and trauma-induced fibroblastic response characterized by large aggregations of plasma cells, macrophages and helper T lymphocytes. The reactive areas rapidly matured into noninflamed fibrocytic tissue. The suppressive effect of CsA appears responsible for removal of sectors of the normal immune response and, in combination with an elevated number of macrophages, may be instrumental in initiating a fibrous hyperplastic response.