Experimental Treatment that Showed Great Improvement in the Clinical Condition of a Patient with Ligneous Gingivitis Caused by Plasminogen Deficiency: Case Report |Biomedgrid

Plasminogen is an enzyme that has an important function in homeostasis, and in wound healing [1]. It is linked to fibrin dissolution, and therefore, of thrombus. It has an important role in macrophage recruitment during inflammatory responses, in invasion and metastasis of tumors cells, wound-healing, tissue remodeling, neurite outgrowth and with skeletal muscle tissue [2]. Serum rates usually are expected to be between 70–140%. Plasminogen deficiency is a rare autosomal recessive disease. It is congenital [2,3] and is possible to find people from the patient family with activity levels of plasminogen rate <50%, without the presence of ligneous lesions. This highlights the variability in presentation of this disorder and makes tight correlation of levels with hard clinical symptoms [1]. Patients with plasminogen deficiency usually have a very reduced wound-healing capability, mainly in mucous membranes, as conjunctiva or gum1, that is why lesions in these types of area are usually rich in fibrin (due to lack of proteolytic capacity) [3,4]. One consequence of plasminogen deficiency is Ligneous conjunctivitis. Clinical signs are usually: Chronic lacrimation, conjunctival hyperemia, low immunity, lesions conjunctival membrane and/or in other mucosal tissues. It shows some pseudomembranes growth, that are deeply stuck in the conjunctiva of the eyelid. Their removal tends to cause bleeding because the area is very vascularized [5]. Besides the ocular region, other mucous membranes may be involved, such as oral, nasopharyngeal, gum, trachea, endometrium and vagina [6]. Several cases of ligneous conjunctivitis and/or gingivitis were found in association with plasminogen deficiency type I [6].