“Strawberry like” gingivitis being the first sign of Wegener's granulomatosis
Received 17 March 2009; received in revised form 14 April 2009; accepted 25 April 2009. published online 01 June 2009.
Abstract
Wegener's granulomatosis (WG) is a rare granulomatous necrotizing vasculitis of small vessels, affecting vascular structures having predilection for upper airways. If untreated WG can be lethal. WG is also known to cause oral mucosal lesions. We report a case of WG that was first diagnosed on oral gingival mucosa.
A 51-year old woman was referred to a specialized dentist because of consistent irritative buccal gingival hyperplasia that did not react to conservative and microbial treatment. The lesion was biopsied and the diagnosis was suggestive for WG. Patient was further referred to the Department of Rheumatology and the diagnose of WG was confirmed and treated. The oral lesions cured totally. This case emphasizes the importance to recognize the oral manifestation of WG to get proper medication as soon as possible and avoid serious systemic tissue damage.
aDepartment of Oral and Maxillofacial Diseases, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
bDepartment of Internal Medicine, Division of Rheumatology, HUS, Helsinki University Central Hospital, Helsinki, Finland
cDepartment of Pathology, Haartman Institute, University of Helsinki, Helsinki, Finland
dDepartment of Oral Pathology, Institute of Dentistry, Helsinki University, Helsinki, Finland
eHUSLAB, Helsinki University Central Hospital, Helsinki, Finland
Corresponding author. Department of Pathology, Haartman Institute, P.O. Box 21, 00014 University of Helsinki, Finland. Tel.: +358 504271914; fax: +358 919126551.
ABSTRACT