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Labrador AJP, Valdez LHM, Marin NRG, Ibazetta KAR, Chacón JAL, Fernandez AJV, Valencia MSV, Marchant SW, Sanchez KBT, Villacrez C. Oral granulomatosis with polyangiitis a systematic review. Clin Exp Dent Res 2023; 9:100-111. [PMID: 36600477 PMCID: PMC9932239 DOI: 10.1002/cre2.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Granulomatosis with polyangiitis is an unusual multisystemic inflammatory disease, with vasculitis of small- and medium-sized vessels, with a predilection for upper lower airways and kidneys. The etiology remains unknown although it may originate from different stimuli, in genetically susceptible patients. MATERIALS AND METHODS A detailed database search was performed. The variables were demographics, localization, histopathological findings, antineutrophil cytoplasmic autoantibody, cytoplasmic (c-ANCA) tests, treatment, and follow-up. RESULTS Fifty-two cases were identified; the mean age was 49.6 years, with a range from 6 to 87 years. It was most frequently seen in females (57.7%). The most common race was white (59.6%). The most frequent location was in the maxillary gingiva (28.8%), followed by both the upper and lower gingiva (19.2%). The most common clinical presentation was "strawberry gingivitis" (61.5%). The main symptom was pain, in 50%. Regarding the c-ANCA test, it was positive in 71.2% of cases. The most common therapy was prednisone and cyclophosphamide, utilized in 51.9%. The average follow-up was 23.6 months, and 88.5% of patients were still alive at follow-up. CONCLUSION The diagnosis initially was difficult to establish, an early diagnosis and treatment are mandatory. If untreated the disease can be associated with morbidity and mortality. For the oral clinician, this disease needs to be addressed in the differential diagnosis of oral lesions.
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Affiliation(s)
- Alberto J. Peraza Labrador
- Centro de Odontologia IntegralAcariguaVenezuela
- Department of Diagnostic SciencesTexas A&M University School of DentistryTexasEstados Unidos
| | | | | | | | | | | | | | | | | | - Cesar A. Villacrez
- Dental Implant DepartmentUniversidad Señor de SIPAN Dental SchoolLimaPeru
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Dhalkari CD, Patil SC, Indurkar MS. Strawberry gingivitis - First sign of Wegener's granulomatosis. J Oral Maxillofac Pathol 2020; 24:172-175. [PMID: 32508469 PMCID: PMC7269271 DOI: 10.4103/jomfp.jomfp_3_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 09/06/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022] Open
Abstract
Wegener's Granulomatosis (WG) is an immunologically mediated rare multisystem disease characterized by necrotizing granulomatous inflammation affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. WG oral lesions are reported to occur in 6%–13% of patients; they were an initial presenting feature in only 2% of cases. A case of strawberry gingivitis as the first sign of WG presented with erythematous and painful localized gingival enlargement affecting the maxillary anterior region of jaw in a 17-year-old boy is reported here. Correlation of histopathology with routine hematoxylin and eosin and special stains such as Grocott-Gomori's methenamine-silver nitrate and periodic acid–Schiff, peripheral blood smear, chest radiographs, Mantoux test and clinical presentation were established in diagnosing this rare entity. By the above-mentioned procedures, we arrived at the diagnosis of WG. The aim of reporting this case was to emphasize that, the dental surgeon often being the first person to examine the oral cavity, should be familiar with the typical appearance of gingiva as “strawberry gingivitis,” its clinical course, diagnostic parameters and adequate management of WG.
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Affiliation(s)
- Chandulal D Dhalkari
- Department of Periodontology and Implantology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Sayali Chandrakant Patil
- Department of Periodontology and Implantology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
| | - Maya S Indurkar
- Department of Periodontology and Implantology, Government Dental College and Hospital, Aurangabad, Maharashtra, India
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3
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Gingival Swelling as the Initial Manifestation of Granulomatosis with Polyangiitis. Head Neck Pathol 2020; 15:244-253. [PMID: 32096099 PMCID: PMC8010058 DOI: 10.1007/s12105-020-01144-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/11/2020] [Accepted: 02/13/2020] [Indexed: 12/30/2022]
Abstract
We describe a case of granulomatosis with polyangiitis (GPA; formerly named Wegener granulomatosis) that presented initially as florid areas of gingival swelling. The patient also had upper respiratory symptoms that included sinus congestion and cough of recent onset. Clinical-pathologic correlation aided the interpretation of non-specific biopsy findings and immediate referral to an appropriate medical specialist. Treatment was rendered at an early stage of disease with a good response to date. Review of the literature indicates that gingival swelling, often with the characteristic appearance of "strawberry gingivitis" may represent the initial sign of disease in 2% of patients with GPA. Biopsy of gingival lesions often shows a non-specific histologic appearance that should be interpreted in the context of the clinical appearance and pertinent medical history. The clinical investigations that lead to definitive diagnosis and treatment are presented to facilitate the management of this uncommon but potentially fatal condition.
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4
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Strawberry gingivitis: Challenges in the diagnosis of granulomatosis with polyangiitis on gingival specimens. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:e202-e207. [DOI: 10.1016/j.oooo.2019.07.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 07/10/2019] [Accepted: 07/21/2019] [Indexed: 11/22/2022]
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5
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Lanzel E, Syrbu SI, Hellstein JW, Stein KM, Welander S, Sousa Melo SL. Destructive soft tissue mass in the maxilla/maxillary sinus. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 125:510-515. [PMID: 28089462 DOI: 10.1016/j.oooo.2016.10.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 10/18/2016] [Accepted: 10/23/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Emily Lanzel
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA.
| | - Sergei I Syrbu
- Department of Pathology, Caver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - John W Hellstein
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Kyle M Stein
- Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Sean Welander
- Division of Oral and Maxillofacial Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Saulo L Sousa Melo
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry, University of Iowa, Iowa City, IA, USA
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6
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Travis WD. Common and uncommon manifestations of wegener's granulomatosis. Cardiovasc Pathol 2015; 3:217-25. [PMID: 25990999 DOI: 10.1016/1054-8807(94)90032-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/1994] [Accepted: 04/13/1994] [Indexed: 11/29/2022] Open
Affiliation(s)
- W D Travis
- Department of Pulmonary and Mediastinal Pathology, Armed Forces Institute of Pathology, Washington, D.C., USA
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7
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Wegener's granulomatosis: Case report and review of the literature. DENTAL CADMOS 2012. [DOI: 10.1016/j.cadmos.2011.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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8
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9
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Affiliation(s)
- A E Chambers
- Department of Oral Medicine, Newcastle Dental Hospital and School, Newcastle Upon Tyne, UK.
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10
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Chee HK. Wegener's Granulomatosis: Strawberry Gums of the Oral Cavity. PROCEEDINGS OF SINGAPORE HEALTHCARE 2012. [DOI: 10.1177/201010581202100114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Wegener's Granulomatosis is a rare and potentially life-threatening vasculitic disease of unknown origin. The diagnosis of Wegener's Granulomatosis is made on the basis of clinical presentation, positivity for serum c-ANCA and histologic examination of the lesions. This report details a case of limited Wegener's Granulomatosis with hyperplastic gingivitis lesions presenting as an initial manifestation of Wegener's Granulomatosis. The resemblance of the affected gums to over-ripe strawberries is pathognomonic of this condition and is thus highlighted. Because of the rarity of Wegener's Granulomatosis presenting initially in the oral cavity, clinicians should be alerted to the characteristic appearance of “strawberry gingivitis”.
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Affiliation(s)
- Hoe Kit Chee
- Department of Restorative Dentistry, National Dental Centre Singapore
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11
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Xing X, Zhang T, Wang X. Pediatric Wegener's granulomatosis with oral ulcers and progressive periodontitis: a case report. ACTA ACUST UNITED AC 2011; 112:e1-5. [PMID: 21868265 DOI: 10.1016/j.tripleo.2011.05.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Revised: 05/23/2011] [Accepted: 05/24/2011] [Indexed: 10/17/2022]
Abstract
Wegener's granulomatosis (WG) is a rare multisystem disorder. Although it can occur at any age, it is rarely observed in children. Oral manifestations, which are present in fewer than 10% of patients, include oral ulceration, nonhealing extraction sockets, and the most common oral lesion, hyperplastic gingivitis, which is known as "strawberry gingivitis." We report the unusual case of a 6-year-old boy with WG who presented with atypical oral manifestations, including severe progressive periodontitis accompanied by oral ulcers, before the development of systemic symptoms. Although WG is rare, this case emphasizes the importance of considering the diagnosis in those who present with progressive and atypical oral disease, as prompt treatment of the systemic illness can significantly improve outcome.
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Affiliation(s)
- Xianghui Xing
- School of Stomatology, Fourth Military Medical University, Xi'an, China
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12
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Siar CH, Yeo KB, Nakano K, Nagatsuka H, Tsujigiwa H, Tomida M, Ng KH, Kawakami T. Strawberry gingivitis as the first presenting sign of Wegener's granulomatosis: report of a case. Eur J Med Res 2011; 16:331-4. [PMID: 21813375 PMCID: PMC3352006 DOI: 10.1186/2047-783x-16-7-331] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Wegener's granulomatosis is a rare multi-system disease characterized by the classic triad of necrotizing granulomas affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. Oral lesions as a presenting feature are only encountered in 2% of these cases. Hyperplastic gingival lesions or strawberry gingivitis, is a characteristic sign of Wegener's granulomatosis. The latter consists of reddish-purple exophytic gingival swellings with petechial haemorrhages thus resembling strawberries. Recognition of this feature is of utmost importance for timely diagnosis and definitive management of this potentially fatal disease. A case of strawberry gingivitis as the first presenting sign of Wegener's granulomatosis affecting a 50-year-old Malay male is reported here. The differential diagnosis of red lesions that may present in the gingiva is discussed.
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Affiliation(s)
- C H Siar
- Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Ruokonen H, Helve T, Arola J, Hietanen J, Lindqvist C, Hagstrom J. "Strawberry like" gingivitis being the first sign of Wegener's granulomatosis. Eur J Intern Med 2009; 20:651-3. [PMID: 19782931 DOI: 10.1016/j.ejim.2009.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Revised: 04/14/2009] [Accepted: 04/25/2009] [Indexed: 11/21/2022]
Abstract
Wegener's granulomatosis (WG) is a rare granulomatous necrotizing vasculitis of small vessels, affecting vascular structures having predilection for upper airways. If untreated WG can be lethal. WG is also known to cause oral mucosal lesions. We report a case of WG that was first diagnosed on oral gingival mucosa. A 51-year old woman was referred to a specialized dentist because of consistent irritative buccal gingival hyperplasia that did not react to conservative and microbial treatment. The lesion was biopsied and the diagnosis was suggestive for WG. Patient was further referred to the Department of Rheumatology and the diagnose of WG was confirmed and treated. The oral lesions cured totally. This case emphasizes the importance to recognize the oral manifestation of WG to get proper medication as soon as possible and avoid serious systemic tissue damage.
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Affiliation(s)
- Hellevi Ruokonen
- Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital and University of Helsinki, Helsinki, Finland
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14
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Compilato D, Cirillo N, Termine N, Kerr AR, Paderni C, Ciavarella D, Campisi G. Long-standing oral ulcers: proposal for a new `S-C-D classification system’. J Oral Pathol Med 2008; 38:241-53. [PMID: 19141062 DOI: 10.1111/j.1600-0714.2008.00722.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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16
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Carter LM, Brizman E. Lingual infarction in Wegener's Granulomatosis: a case report and review of the literature. Head Face Med 2008; 4:19. [PMID: 18718013 PMCID: PMC2531096 DOI: 10.1186/1746-160x-4-19] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2007] [Accepted: 08/21/2008] [Indexed: 11/12/2022] Open
Abstract
Wegener's granulomatosis (WG) is a multi-system disease, characterised by the triad of necrotising granulomata affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. Oral lesions are associated with up to 50% of cases, although are rare as a presenting feature. The most common oral lesions associated with WG are ulceration and strawberry gingivitis. We review the literature regarding oral manifestations of WG and present a case of lingual infarction, an extremely rare oral lesion associated with WG, in a severe, rapidly progressive and ultimately fatal form of the disease.
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Affiliation(s)
- Lachlan M Carter
- Maxillofacial Surgery, Leeds Dental Institute, Clarendon Way, Leeds, UK.
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Hernández G, Serrano C, Porras L, Lopez-Pintor R, Rubio L, Yanes J. Strawberry-Like Gingival Tumor as the First Clinical Sign of Wegener's Granulomatosis. J Periodontol 2008; 79:1297-303. [DOI: 10.1902/jop.2008.070572] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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18
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Stewart C, Cohen D, Bhattacharyya I, Scheitler L, Riley S, Calamia K, Migliorati C, Baughman R, Langford P, Katz J. Oral manifestations of Wegener's granulomatosis: a report of three cases and a literature review. J Am Dent Assoc 2007; 138:338-48; quiz 396, 398. [PMID: 17332039 DOI: 10.14219/jada.archive.2007.0166] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hyperplastic granular gingivitis or "strawberry gingivitis" is a rare manifestation of Wegener's granulomatosis (WG), but it is nearly pathognomonic for this multisystem autoimmune vasculitis. The dentist may be the first health care professional to see patients with symptoms and findings of this condition. Early diagnosis and treatment is the most important factor in the management of this potentially fatal disease. METHODS The authors present three case reports that demonstrate the disease spectrum and conducted a literature review focused on current understanding of this disease. RESULTS The first patient had only the classic gingival manifestations of the disease. The second patient had simultaneous typical gingival lesions, as well as dermatologic findings. The third patient had an atypical oral presentation of aphthous ulcers and erythematous gingiva, as well as respiratory and genital involvement. Reaching a definitive diagnosis sometimes is challenging owing to the subtle onset of the disease and variable clinical and laboratory findings. CONCLUSION AND CLINICAL IMPLICATIONS Clinicians should be familiar with the broad variety of oral and systemic components of WG, as well as strategies to facilitate prompt disease recognition and to provide continued oral health care to these medically complex patients.
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Affiliation(s)
- Carol Stewart
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, University of Florida, College of Dentistry, Gainesville, FL 32610, USA.
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Ettl T, Pistner H, Schwarz S, Reichert TE, Driemel O. [Foudroyant course of a therapy resistent Wegener's granulomatosis with negative c-ANCA]. ACTA ACUST UNITED AC 2007; 11:73-80. [PMID: 17406921 DOI: 10.1007/s10006-007-0052-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Accepted: 02/20/2007] [Indexed: 11/25/2022]
Abstract
BACKGROUND Wegener's Granulomatosis is a rare systemic disease characterized by the triad of necrotizing granulomas of blood vessels, upper respiratory tract, and kidneys. Diagnosis depends on clinical symptoms (ACR-criteria), detection of serum circulating antineutrophil cytoplasmic antibodies (c-ANCA) and bioptical histopathology. CASE-REPORT A 34-year-old patient presented with intraoral ulcerating, necrotizing inflammations of the palate and the gingiva. Chest radiograph (nodules, infiltrates), urin analysis (red blood cell casts) being inconspicuous Wegener's granulomatosis was diagnosed by histopathology of an intraoral incisional biopsy. Conventional therapy with corticosteroids and cyclophosphamide relapsed while the disease was taking a progressive course (pulmonary infiltrates, necrotizing vasculitides all over the common integument). The patient died of cardiac decompensation three months after diagnosis. c-ANCAs were not present at any time of disease. CONCLUSIONS 1. Symptoms of the head and neck are manifest in up to 95% of Wegener's granulomatosis. So knowledge of the disease is important for dentists and oral and maxillofacial surgeons in spite of its low prevalence. 2. c-ANCA-titers do not reflect disease activity. Negative c-ANCAs do not exclude Wegener's granulomatosis. 3. Wegener's granulomatosis can take a progressive, therapy resistent course.
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Affiliation(s)
- T Ettl
- Universität Regensburg, Klinik und Poliklinik für Mund, Kiefer- und Gesichtschirurgie, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
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20
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Ponniah I, Shaheen A, Shankar KA, Kumaran MG. Wegener's granulomatosis: The current understanding. ACTA ACUST UNITED AC 2005; 100:265-70. [PMID: 16122651 DOI: 10.1016/j.tripleo.2005.04.018] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2004] [Revised: 03/23/2005] [Accepted: 04/08/2005] [Indexed: 10/25/2022]
Abstract
Wegener's granulomatosis (WG) is a rare systemic disease characterized by necrotizing granulomatous inflammation of the upper and lower respiratory tract, glomerulonephritis and vasculitis. It occurs as a limited form or generalized form and usually presents with nonspecific symptoms in its early stages, making the diagnosis of this disease more elusive. Strawberry gingivitis is the most common oral manifestation and is characteristic. Prompt recognition of this early manifestation is of utmost importance for the institution of early treatment, thereby avoiding serious complications. The present paper selectively reviews the literature regarding the current status of WG with respect to diagnosis, laboratory features, and treatment.
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Affiliation(s)
- I Ponniah
- Department of Oral and Maxillofacial Pathology, Tamil Nadu Government Dental College and Hospital, India.
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Crean SJ, Adams R, Bennett J. Sublingual gland involvement in systemic Wegener's granulomatosis: a case report. Int J Oral Maxillofac Surg 2002; 31:104-6. [PMID: 11936391 DOI: 10.1054/ijom.2001.0144] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Wegener's granulomatosis is a systemic vasculitis characterized by necrosis, granulomatosis and inflammation. The usual targets are extra-oral, although salivary gland involvement has been recognized, usually confined to parotid and submandibular glands. A case report is presented of sublingual gland presentation, confirmed on biopsy, which proceeded to systemic involvement. Some evidence suggests that salivary gland involvement, if recognized, may lead to an early diagnosis and the potential for earlier therapeutic intervention.
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Affiliation(s)
- St-J Crean
- Oral & Maxillofacial Surgery, University Hospital of Wales, Cardiff.
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Abstract
The purpose of this article is to describe the clinical and microscopic findings of oral lesions of Wegener's granulomatosis (WG) in a patient who presented with a limited form of the disease. cANCA estimation remains the definitive diagnostic test for WG but we recommend that both the immunofluorescent and ELISA forms of analysis are performed, and care should be exercised in the interpretation of results. Because both serological tests may be negative in a significant proportion of cases, a tissue biopsy is required to help establish the diagnosis. The biopsy needs to be sufficiently deep to include the granulomatous inflammation required for diagnosis, and multiple histological levels on the tissue may be needed to identify vasculitis.
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Affiliation(s)
- G Rahilly
- Orthodontics Department, St. James's University Hospital, Beckett Street, Leeds LS9 7TF, UK
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Clark WJ, Broumand V, Ruskin JD, Davenport WL. Erythematous, granular, soft tissue lesion of the gingiva. J Oral Maxillofac Surg 1998; 56:962-7. [PMID: 9710191 DOI: 10.1016/s0278-2391(98)90659-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- W J Clark
- University of Florida College of Dentistry, Department of Oral & Maxillofacial Surgery, Gainesville 32610-0416, USA
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Manganaro AM, Bryant AW. Speech aid prosthesis for a patient with Wegener's granulomatosis: a clinical report. J Prosthet Dent 1997; 77:346-7. [PMID: 9104708 DOI: 10.1016/s0022-3913(97)70156-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A speech aid prosthesis was fabricated to correct the hypernasality of the speech of a patient. The hypernasality was caused by velopharyngeal insufficiency related to Wegener's granulomatosis. Speech aids have been used for cleft palate patients for whom surgical treatment was not indicated, surgical treatment was declined, or before surgical treatment as an evaluation for possible speech improvement. A speech aid prosthesis can be an important treatment modality when surgical correction of a velopharyngeal defect is not indicated.
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Affiliation(s)
- A M Manganaro
- Department of Oral and Maxillofacial Surgery, United States Army Dental Corps, USA DENTAC, USA
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Lustmann J, Segal N, Markitziu A. Salivary gland involvement in Wegener's granulomatosis. A case report and review of the literature. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1994; 77:254-9. [PMID: 7695676 DOI: 10.1016/0030-4220(94)90294-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Late involvement of the parotid gland in a patient with a limited form of Wegener's granulomatosis is presented. We report the full course of the disease and the difficulties encountered in determining the nature of the parotid enlargement. We discuss the contribution of computerized tomography and ultrasonography to elucidate parenchymal morphologic findings and radioisotope studies to determine the functional capacity of the gland. In cases of Wegener's granulomatosis with salivary symptoms, measurement of salivary gland functional capacity, in addition to the c-ANCA test, may help to monitor disease activity. Despite the rarity of the disease, in cases when granulomatous diseases are considered, it should be recognized that Wegener's granulomatosis may result in salivary gland involvement.
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Affiliation(s)
- J Lustmann
- Department of Oral and Maxillofacial Surgery, Hebrew University-Hadassah, School of Dental Medicine, Jerusalem, Israel
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