アムロジピン誘発性歯肉過成長：薬剤の中止と再開に対する歯周反応

Amlodipine-induced gingival overgrowth: periodontal responses to stopping and restarting the drug.

抄録

アムロジピンによって誘発された歯肉過成長（GO）の女性の症例を紹介する。症例は49歳の日本人女性で，アムロジピンを服用中であったが，検査で歯肉の過剰増殖と腫脹を認めた．GOに対して特に歯周治療は行わなかったが，開業医と相談の上，アムロジピンをACE阻害薬に変更した．2ヵ月以内に、アムロジピンの中断により歯周病状態は著しく改善した。高血圧のコントロールに失敗したため、医師はアムロジピンを再処方した。3ヵ月後、歯肉の過繁殖が再発したが、薬剤の減量と歯周治療により、その重症度は元の歯周病状態より軽減した。この経験は，GOを誘発する薬剤を一時的に中断することで，外科的治療の助けを借りずに歯周状態を改善できることを示唆している．

A case history of a woman with gingival overgrowth (GO) induced by amlodipine is presented. A 49-year-old Japanese woman, who was taking amlodipine, had gingival overgrowth and swelling on examination. No specific periodontal treatment was provided to the patient for the GO; however, the amlodipine was replaced with an ACE inhibitor after consultation with her medical practitioner. Within two months, the suspension of amlodipine resulted in a significant improvement in her periodontal condition. Failure to control the hypertension caused the physician to re-prescribe amlodipine. After three months, the gingival overgrowth returned; however, its severity was less when compared with the original periodontal condition, due to reduction in drug dose and periodontal therapy. This experience suggests that temporary suspension of a drug which can induce GO can improve the periodontal condition without the aid of surgical treatment.