Role of gingival manifestation in diagnosis of granulomatosis with polyangiitis (Wegener’s granulomatosis)
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Purpose: This report describes a case of granulomatosis with polyangiitis (GPA) in whichthe gingival manifestation was crucial in both making an early diagnosis and possibly indeciding the approach to treatment. Methods: A 57-year-old sailor presented to the Department of Dentistry at Ulsan UniversityHospital complaining of gingival swelling since approximately 2 months. He had orofacialgranulomatous lesions and the specific gingival manifestation of strawberry gingivitis. Results: The diagnosis of GPA was made on the basis of clinical symptoms and signs, andconfirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifyingtherapy regimen that included methotrexate and prednisone. Conclusions: Identification of the gingival manifestation of the disease permitted an earlydiagnosis and prompt therapy in a disease in which time is a crucial factor. Because of itsrapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.
Abstract
Purpose: This report describes a case of granulomatosis with polyangiitis (GPA) in whichthe gingival manifestation was crucial in both making an early diagnosis and possibly indeciding the approach to treatment. Methods: A 57-year-old sailor presented to the Department of Dentistry at Ulsan UniversityHospital complaining of gingival swelling since approximately 2 months. He had orofacialgranulomatous lesions and the specific gingival manifestation of strawberry gingivitis. Results: The diagnosis of GPA was made on the basis of clinical symptoms and signs, andconfirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifyingtherapy regimen that included methotrexate and prednisone. Conclusions: Identification of the gingival manifestation of the disease permitted an earlydiagnosis and prompt therapy in a disease in which time is a crucial factor. Because of itsrapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.
참고문헌 (29)
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