Granulomatosis with polyangiitis (GPA) is a rare multisystem disease characterized by a triad of necrotizing granulomas affecting the upper and lower respiratory tract, vasculitis and glomerulonephritis. Oral lesions are seen in 6-13% of cases, although not life threatening but might be the first symptoms reported by the patient. Here we present a case of gingival growth, later diagnosed as GPA owing to the timely recognition by the dentist. A 33-year-old female reported for evaluation of soft tissue growth in her lower left back tooth region present for past 3 months. She had no relevant medical or family history. Clinically it looked like a benign hypertrophic gingival enlargement. The histopathological picture was suggestive of vasculitis and nonspecific granuloma formation. On further examination altered Renal Function Test and cavitating granulomas were noted in her lungs along with a positive cytoplasmic ANCA (c-ANCA) test which led to the diagnosis of GPA.
Keywords: C-ANCA; granulomatosis with polyangiitis; oral manifestations; palatal ulcer; strawberry gingivitis; vasculitis.
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