Uremic stomatitis

A 42-year-old woman with history of IgA nephropathy with chronic kidney disease, Stage 5 and hypertension presented with poor appetite, generalized itchy and dysgeusia with decreasing sensation to salt. She denied smoking and betel nuts use. Extra-oral examination revealed petechiae on her back and subconjunctival hemorrhage on her left eye. Intraoral examination revealed the presence of white plaques predominantly involving the lateral borders and dorsal surface of the tongue (Figure 1a), floor of the mouth and buccal mucosae (Figure 1b). The results of blood tests were as follows: white blood cell count of 6.62 × 103/ μl; platelet count of 106 × 103/ μl; Hemoglobin of 7.4 g/dl, blood urea nitrogen (BUN) of 205 mg/dl and creatinine of 18.9 mg/dl. The virus, fungus and microbiology survey were unremarkable. Pathological report of the lesion was unavailable because the patient declined biopsy. The white lesions almost resolved completely and the taste disturbance improved remarkably after 4 sessions of hemodialysis within 5 days accompanied with lowering of BUN levels. Figure 1(a) Intraoral examination revealed the presence of white plaques predominantly involving the lateral borders and dorsal surface of the tongue. (b) White plaques involving the floor of the mouth and buccal mucosae.
Source: QJM - Category: Internal Medicine Source Type: research