Numb Chin in Sickle Cell Anemia During Pregnancy

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A 32-year-old Angolan woman with sickle cell anemia presented with severe pain of the left mandible in the 27^th week of gestation. She also had marked hypesthesia of the left lower lip and chin and of the teeth in the left lower quadrant. Clinical chemistry demonstrated hemolytic anemia corresponding to a sickle cell crisis. On magnetic resonance imaging, a T2-weighted fat-suppressed sequence revealed edema of the alveolar bone. Because of the patient’s pregnancy, no contrast medium was administered to exclude malignancy. We diagnosed numb chin syndrome (NCS) due to a sickle cell crisis. Microinfarctions cause osseous edema with consecutive dysfunction of the inferior alveolar nerve (a branch of the mandibular nerve). In Germany, NCS is mostly caused by malignancies, but several case reports have described it as a manifestation of sickle cell crises, the risk of which is elevated during pregnancy. Our patient’s symptoms had regressed completely by the end of 1 month of purely analgesic treatment.

Dr. med. Benjamin Wolf, Abteilung für Geburtsmedizin, Universitätsklinikum Leipzig, [e-mail]

Dr. med. Daniel Gräfe, Abteilung für Kinderradiologie, Universitätsklinikum Leipzig

Prof. Dr. med. Holger Stepan, Abteilung für Geburtsmedizin, Universitätsklinikum Leipzig

Conflict of interest statement: The authors declare that no conflict of interest exists.

Translated from the original German by David Roseveare.

Cite this as: Wolf B, Gräfe D, Stepan H: Numb chin in sickle cell anemia during pregnancy. Dtsch Arztebl Int 2020; 117: 808. DOI: 10.3238/arztebl.2020.0808b