Unprovoked periodontal hemorrhage, life-threatening anemia and idiopathic thrombocytopenia purpura: an unusual case report.

Spontaneous gingival bleeding can occasionally be the only sign of systemic bleeding problems. The diagnosis and management of such conditions may challenge the skills of both the hematologist and the oral physician. We present this patient because of several confusing phenomena that were encountered: unprovoked periodontal hemorrhage, which endangered the life of an otherwise asymptomatic young adult male; (especially unusual was a platelet count above 150,000 cells per microliter of blood), and presentation of idiopathic thrombocytopenia purpura through spontaneous periodontal hemorrhage alone. This case history also highlights the fact that medical intervention to correct the underlying aberration of hemostasis is necessary for local dental measures to successfully stop bleeding. In contrast with the definition of thrombocytopenia, the "within normal" count of platelets should not exclude the possibility of idiopathic thrombocytopenia purpura; a fact that, if ignored, can make the diagnosis and management of bleeding troublesome.