Abstract:

This article analyzed a boy with Alport syndrome who has been taking amlodipine besylate for a long time . The 15-year-old boy was diagnosed with Alport syndrome at 7 years and 7 months old (May 2016), and progressed to chronic kidney disease stage 5 at 10 years and 4 months old (February 2019). He started peritoneal dialysis in March 2019, and had been taking various antihypertensive drugs for many years due to the existence of malignant hypertension. However, his blood pressure was not well controlled, mostly in the 130-150/90-110 mmHg (1 mmHg= 0.133 kPa) range. Gingival hyperplasia occurred in February 2023 and gradually worsened. CT examination, bone marrow cell blood examination, physical examination, and medication history were performed to diagnose the gingival hyperplasia associated with calcium channel blockers (CCB). Gingival hyperplasia improved significantly after amlodipine reduction. The exact mechanism of drug-induced gingival hyperplasia is not fully understood. Whether the severe gingival hyperplasia manifestation is related to the gene mutation causing collagen synthesis abnormality or increased drug susceptibility in the patient's underlying disease of Alport syndrome needs further research.

Key words:

Amlodipine besylate, Gingival hyperplasia, Children, Alport syndrome

摘要：

本文对1例长期口服苯磺酸氨氯地平致Alport综合征患儿重度牙龈增生进行分析并文献复习。患儿男，15岁，7岁7个月时（2016年5月）确诊Alport综合征，10岁4个月时（2019年2月）进展为慢性肾脏病5期。2019年3月开始腹膜透析治疗，因存在恶性高血压，需常年口服多种降压药，但血压控制效果不理想，多处于130～150/90～110 mmHg（1 mmHg=0.133 kPa）。2023年2月开始出现牙龈增生，逐渐加重。完善CT检查、骨髓细胞学检查等，结合查体、用药史等，诊断为钙通道阻滞剂相关药物性牙龈增生。减停苯磺酸氨氯地平后，牙龈增生明显好转。严重的牙龈增生表现是否与基因突变引起牙龈胶原合成异常或药物易感性增加有关，有待进一步研究。

关键词:

苯磺酸氨氯地平, 牙龈增生, 儿童, Alport综合征