BMJ Case Reports 2016; doi:10.1136/bcr-2016-217457

Acute promyelocytic leukaemia: looking through ‘gums’

Editor's Choice
  1. Karthik Bommannan2
  1. 1Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Haematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Pankaj Malhotra, hematpgi{at}
  • Accepted 7 November 2016
  • Published 30 November 2016


Examination of the oral cavity provides valuable clues to a large number of systemic disorders. Gum hypertrophy is usually associated with myelomonocytic and monocytic subtypes of acute myeloid leukaemia.1 Its occurrence in a case of acute promyelocytic leukaemia (APL) is unusual.1

We describe a 28-year-old man from India who presented to our hospital with a 2-week history of easy fatiguability and gum bleeding. Examination revealed pallor and marked gum hypertrophy (figure 1). Blood investigations showed haemoglobin 50 g/L, white cell count 5.4×109/L, differential counts 95% promyelocytes, 3% myelocytes, 1% metamyelocytes and 1% …

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