ORIGINAL RESEARCH Journal of Case Reports in Dental Medicine (J Case Rep Dent Med) January 2020, Volume 2, Number 1: 5-8 5 http://jcrdm.org © 2019 JCRDM. Published by Faculty of Dentistry, Hasanuddin University. All rights reserved. Objective: Thalasemia is an inherited blood diseases cause which abnormalities systemically and intraorally. This case report to discuss management of Aphthous-Like Ulcer in 24 year old man with Thalasemia β Intermedia and need blood transfusion every month. Ulcer occured 2 days before transfusion. Methods: Based on history, clinical examination, hematologi and ferritin tests. ferritin tests. Results: The diagnosis was Aphthous Like ulcer induce by trauma. Patient was treated using anti-inflammatory mouthwash and recovery was achieved within 3 weeks follow-up. Conclusion: Management of oral manifestation in Thalasemia pa- tient need multidiciplinary approach to obtain successful therapy . Keywords: Aphthous-like ulcer, Oral ulcer, Thalassemia β-intermedia Cite this Article: Riyanto DＬ Soebadi B, Hadi P, Radithia D. 2020. Management of aphthous-like ulcer induce by trauma in patient with thalassemia beta intermedia: a case report. Journal of Case Reports in Dental Medicine. 2(1): 5-8. DOI: 10.20956/jcrdm.v2i1.110 Management of aphthous-like ulcer induce by trauma in patient with thalassemia beta intermedia: a case report Dahlia Riyanto, * Bagoes Soebadi, Priyo Hadi, Desiana R｡､ｩｴｨｩ｡ Abstract Introduction The term “thalassemia” comes from the Greek word “Thalassa” which means sea and “Haema” which means blood. 1 Thalassemia is one of the most common autosomal recessive blood disorders has been found in several countries with the main distribution in the areas known as the Thalassemia Belt, such as the Mediterranean, Middle East, Southern Asia, China Peninsula, Pacific Islands and Southeast Asia, including Indonesia with an incidence of 5-20%. 2-4 Thalassemia is caused by a mutation in the gene responsible for the production of hemoglo- bin. Hemoglobin is a protein in red blood cells that carries oxygen, consisting of four protein chains, two globin chains α and two globin chains β arranged into heterotetramers. 2,5 β-thalassemia occurs in two ways: transfer of recessive genes from parents to children and mutations in the Hb β gene on the autosomal chromosome No. 11. The severity of the disease depends on the number of gene mutations present in the patient. According to its severity, β-thalassemia is classified into three types: thalassemia major (TM), thalassemia intermedia (TI), and thalassemia minor. Mutations are characterized as βo or β Ｋ. This βo thalassemia is known as major beta thalassemia where no beta chain production is found and βＫ thalassemia is known as intermediate beta thalassemia where beta chain production is decreases. 3,6 The globin chain imbalance causes hemolysis, which causes mild to severe anemia characterized by hypochromic and microcytic erythrocytes. which causes mild to severe anemia characterized by hypochromic and microcytic erythrocytes. 2,7 Patients with anemia may have atrophic glossitis (AG) or generalized oral mucosal atrophy, recurrent aphthous ulceration (RAU) and tenderness or burning sensation in the oral mucous. RAU is clinically similar to RAS (Recurrent Aphthous Stomatitis) but does not begin in childhood or is associated with other features not related to classical RAS. Presentations like this are called Aphthous Like Ulcers (ALU). 2,8 Case Report A 24-year-old male patient came to Airlangga University Dental Hospital on November 30th 2018, complaining of stomatitis because of being bitten when eating crackers 4 days ago and have not been treated. Patient admit that he often have stomatitis since Ｋ/-1 year ago, usually appearing once every month in different places when the patient is exhausted, stressed or because of a low Hb. The patient had a medical history of Intermedia β Thalassemia since the age of 1.5 years and underwent routine blood transfusion treat- ment once a month. The patient transfusion was 2 days ago with 4 bags of blood. Patient had a medical history of antrain drug allergy. Patient had been treated with folic acid and Feriprox once a day. A medical family history, the patient claimed his father had a history of anemia and hypertension. Results of a complete blood test before transfusion Hb 11.1g / dl, leukocytes: 3250 / mm3, Hematocrit: 32.8%, Thrombocyte: 42,000 / mm3. The res ul ts of bl ood tests after transfusion Department of Oral Medicine, Fac- ulty of Dental Medicine, Universitas Airlangga, Surabaya, Indonesia * Correspondence to: dahliariyanto7358@gmail.com Received: 3 November 2019 Revised: 2 December 2019 Accepted: 26 December 2019 Available Online 1 January 2020