Granulomatosis with polyangitis (WEGENER’S)- Strawberry gingivitis as prime manifestation

Authors : Jesmith Elsa Jacob, Asish Rajasekharan, Tinky Bose C, Ramesh S, Vinimol C

DOI : 10.18231/j.jooo.2019.024

Volume : 5

Issue : 3

Year : 2019

Page No : 96-99

Wegener's granulomatosis (WG) is an immunologically mediated inflammatory disease. Major histological features include a necrotizing vasculitis involving small vessels, extensive “geographic” necrosis, and granulomatous inflammation. Clinical manifestations of WG are protean; virtually any organ can be involved. Further, the spectrum and severity of the disease is heterogeneous, ranging from indolent disease involving only one site to fulminant, multiorgan vasculitis leading to death. This case report documenrts the importance of considering Wegner’s granulomatosis in patients with unique gingival lesions. The most common presenttion is a friable-granular-hyperplastic gingivitis associated with alveolar resorption and tooth mobility. The disease may remain localized to the mouth for several weeks or months before multiorgan involvement occurs. Gingival enlargement is a direct manifestation of Wegener granulomatosis, and it may be pathognomonic. Failure to recognize the clinical lesions can result in delayed diagnosis and treatment, with potentially fatal results. Therefore, the aim of reporting this case was to emphasize that, the dental surgeon often being the first person to examine the oral cavity, should be familiar with the typical appearance of gingival WG as “strawberry gingivitis,” its clinical course as well as diagnostic parameters and adequate management.

Keywords: Strawberry gingivitis, Wegener's granulomatosis, Antineutrophil cytoplasmic bodies, Geographic necrosis.


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