A 25-year-old woman was seen by the parodontology service because of generalized hyperplastic gingival swelling. She was obese, with a body-mass index over 30, but had a normal fasting blood sugar (01/2013: 97 mg/dL); the inflammatory index markers were raised (01/ 2013: ESR: 90 mm/hr; CRP: 1.9 mg/dL; WBC 11.1 /nL). In the absence of evident systemic disease or a history of ingestion of possibly causative drugs, the initial diagnosis was of idiopathic gingival hyperplasia associated wtih chronic parodontitis. Systematic non-surgical parodontal therapy with adjuvant antibiotic treatment yielded only mild improvement. Repeated laboratory testing a year later revealed an elevated fasting blood sugar (03/2014: 204 mg/dL) and an elevated HbA1c (9.5%). Antidiabetic treatment and continued local mechanical treatment resulted in the nearly complete resolution of the gingival hyperplasia.
Thus, patients with gingival hyperplasia should be assessed for possible diabetes mellitus, even if the initial fasting blood sugar is normal.
Initial finding: gingival hyperplasia.
Footnotes
Conflict of interest statement
The authors declare that no conflict of interest exists.