Granulomatosis with polyangiitis - An oral medicine case book




Granulomatosis, polyangiitis


A 33-year-old female patient presented at a private specialist practice (Periodontics and Oral Medicine) with a main complaint of sore and bleeding gums, fever, headaches and sinus pain. The gingiva became irritated, red and swollen five weeks prior to the first consultation in July 2018.

She was referred by her dentist one month after prescribing two consecutive courses of antibiotics and providing oral hygiene instructions to the patient, with no significant improvement. The first prescription was for Augmentin 375mg t.d.s. for 5 days and the second prescription two weeks later was for Amoxycillin 250 mg t.d.s. and Metronidazole 200mg t.d.s. for 5 days. The patient was also using a chlorhexidine mouth rinse.


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Leavitt RY, Fauci AS, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Wegener's granulomatosis. Arthritis Rheum. 1990; 33(8): 1101-7.

Falk RJ, Gross WL, Guillevin L, et al. Granulomatosis with Polyangiitis (Wegener's): An alternative name for Wegener's Granulomatosis. Arthritis Rheum. 2011; 63(4): 863-4.

Klinger H. Grenzformen der periarteritis nodosa. Frankfurt Z Path. 1931; 29: 455-80.

Wegener F. Über generalisierte, septische Gefásserkran-kungen. Verh dtsch pathol ges. 1936; 29: 202-9.

Wegener F. Über eine eigenartige rhinogene Granulomatose mit besonderer Beteilgung des Arterien systems under der Nieren. Beitr Pathol Anat. 1939; 102: 36-68.

Lane SE, Watts R, Scott DG. Epidemiology of systemic vascu-litis. Curr Rheumatol Rep. 2005; 7(4): 270-5.

Szczeklik K, Wtudarczyk A, Wawrzycka-Adamczyk K, et al. Oral manifestations of granulomatosis with polyangiitis -Clinical and radiological assessment. J Dent Sci. 2019; 14(1): 54-60.

Comarmond C, Cacoub P. Granulomatosis with polyangi-itis (Wegener): clinical aspects and treatment. Autoimmun Rev. 2014; 13(11): 1121-5.

Kertesz T, Soowamber M, Bubola J, Psutka DJ, Bradley G. Gingival Swelling as the Initial Manifestation of Granuloma-tosis with Polyangiitis. Head Neck Pathol. 2020; 1-10.

Jennette JC, Falk R, Bacon P, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vas-culitides. Arthritis Rheum. 2013; 65(1): 1-11.

Greco A, Marinelli C, Fusconi M, et al. Clinic manifestations in granulomatosis with polyangiitis. SAGE Publications Sage UK: London, England. 2016.

Pagnoux C. Updates in ANCA-associated vasculitis. Eur J Rheumatol. 2016; 3(3): 122.

Lyons PA, Rayner TF, Trivedi S, et al. Genetically distinct subsets within ANCA-associated vasculitis. N Engl J Med. 2012; 367(3): 214-23.

Xie G, Roshandel D, Sherva R, et al. Association of granulomatosis with polyangiitis (Wegener's) with HLA-DPB1*04 and SEMA6A gene variants: evidence from genome-wide analysis. Arthritis Rheum. 2013; 65(9): 2457-68.

Msallem B, Bassetti S, Matter MS, Thieringer FM. Strawberry gingivitis: Challenges in the diagnosis of granulomatosis with polyangiitis on gingival specimens. Oral Surg Oral Med Oral Pathol Oral Radiol. 2019; 128(6):e202-e7.

Almouhawis HA, Leao JC, Fedele S, Porter SR. Wegener's granulomatosis: A review of clinical features and an update in diagnosis and treatment. J Oral Pathol Med. 2013; 42(7): 507-16.

Muller K, Lin JH. Orbital granulomatosis with polyangiitis (Wegener granulomatosis): clinical and pathologic findings. Arch Pathol Lab Med. 2014; 138(8): 1110-4.

Ponniah I, Shaheen A, Shankar K, Kumaran M. Wegener's granulomatosis: The current understanding. Oral Surg Oral Med Oral Pathol Oral Radiol Oral Endo. 2005; 100(3): 265-70.




How to Cite

Snyman, I., Robinson, L., Van Zyl, A. W., & Van Heerden, W. F. (2020). Granulomatosis with polyangiitis - An oral medicine case book. South African Dental Journal, 75(9), 488–492.

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