Case of strawberry gum associated with polyangiitis granulomatosa in relation to cytoplasmic antineutrophil cytoplasmic antibody.

Autor: Seki, Soju, Mitsuyoshi, Nozomu, Ueta, Ayu, Harada, Kazuma, Uchihashi, Toshihiro, Yokota, Yusuke, Isomura, Emiko Tanaka, Tanaka, Susumu
Zdroj: Journal of Oral & Maxillofacial Surgery, Medicine & Pathology; Jan2024, Vol. 36 Issue 1, p142-146, 5p
Abstrakt: Granulomatosis with polyangiitis (GPA), formerly known as Wegener's granulomatosis, presents histopathologically as necrotizing granulomatous vasculitis of the entire body, necrotizing granulomatosis (mainly of the upper respiratory tract and lungs), and semilunar-forming nephritis. Gingival swelling due to GPA is a rare condition, described as "strawberry gum" because of the fragile, reddish-purple, granulomatous swollen appearance of the gingiva with petechial hemorrhagic plaques, that resembles an overripe strawberry. Herein, we report the case of a 75-year-old man who presented with chief complaints of gingival swelling and pain with generalized gingival bleeding. A 15 × 10-mm granular hemorrhagic mass was observed on the labial gingiva of the left maxillary anterior tooth and multiple other gingivae. After histopathological examination, gingival lesions associated with GPA were suspected. The patient was diagnosed with GPA approximately 9 years ago and had repeated remissions and relapses with prednisolone treatment. Because the cytoplasmic antineutrophil cytoplasmic antibody (cANCA) levels were elevated at the first medical examination, the patient was referred to an immunologist who increased the prednisolone dose, resulting in a decrease in the cANCA levels and resolution of the patient's strawberry gum. The patient's cANCA levels remained low the following year, and strawberry gum did not recur. The cANCA levels have continued to fluctuate after the GAP diagnosis; however, strawberry gum did not develop. Thus, cANCA levels do not predict the development of strawberry gum but must be low to prevent the recurrence of strawberry gum. This case report demonstrated a previously unexplained relationship between strawberry gum and cANCA. [ABSTRACT FROM AUTHOR]
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