15th July 2023

Gingival Hypertrophy and Macroglossia

The causes of gingival hypertrophy and macroglossia are frequently tested in the MRCP examinations. Causes of each are summarised below.

Gingival hypertrophy:

• Inflammatory enlargement
  • Periodontal disease and poor dentition
• Drugs:
  • Anticonvulsants e.g. phenytoin, lamotrigine
  • Calcium-channel blockers (nifedipine in particular)
  • Ciclosporin
• Neoplastic
  • Leukaemia – particularly Acute Myeloblastic Leukaemia (AML)
• Infiltrative
  • Granulomatosis with polyangiitis, sarcoidosis, amyloidosis
• Pregnancy
• Scurvy

Macroglossia

• Inherited
  • Down syndrome
  • Neurofibromatosis 1
  • Mucopolysaccharidosis
  • Glycogen storage disorders
• Acquired
  • Endocrine
    • Acromegaly
    • Hypothyroidism
  • Haematological
    • Amyloidosis
    • Lymphomas
    • Multiple Myeloma
  • Angioedema
  • Carcinoma