Gingival granulomatosis with polyangiitis (Wegener's granulomatosis) as a primary manifestation of the disease

Aust Dent J. 2017 Mar;62(1):102-106. doi: 10.1111/adj.12441. Epub 2016 Dec 23.

Abstract

Granulomatosis with polyangiitis (GPA) is a potentially lethal disease characterized by systemic necrotizing vasculitis, which affects small- and medium-sized blood vessels and is often associated with serum cytoplasmic antineutrophil cytoplasmic antibody. The upper and lower respiratory tract and kidney are the most involved sites, but oral lesions can be identified in 6-13% of the cases, whereas in only 2% of the cases, oral manifestations represent the first signal of the disease usually as gingival swellings or unspecific ulcerations. Without treatment, the mainstay of which is the combination of immunosuppressants and systemic corticosteroids, GPA may run a fatal course. In this report we describe an original case of GPA affecting a 75-year-old female patient referred to our service due to a gingival swelling with 3-month duration. Although the patient was correctly diagnosed and promptly treated, she died 3 months after the initial diagnosis.

Keywords: ANCA; Wegener's granulomatosis; granulomatosis with polyangiitis; necrotizing vasculitis; oral cavity.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use*
  • Aged
  • Antibodies, Antineutrophil Cytoplasmic / blood
  • Diagnosis, Differential
  • Drug Therapy, Combination
  • Fatal Outcome
  • Female
  • Gingival Diseases / blood
  • Gingival Diseases / diagnosis*
  • Gingival Diseases / drug therapy
  • Granulomatosis with Polyangiitis / blood
  • Granulomatosis with Polyangiitis / diagnosis*
  • Granulomatosis with Polyangiitis / diagnostic imaging
  • Granulomatosis with Polyangiitis / drug therapy
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / therapeutic use*

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Antineutrophil Cytoplasmic
  • Immunosuppressive Agents