Dhalkari Chandulal D, Patil Sayali Chandrakant, Indurkar Maya S
Department of Periodontology and Implantology, Government Dental College and Hospital, Aurangabad, Maharashtra, India.
J Oral Maxillofac Pathol. 2020 Jan-Apr;24(1):172-175. doi: 10.4103/jomfp.JOMFP_3_19. Epub 2020 May 8.
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.
韦格纳肉芽肿病（WG）是一种免疫介导的罕见多系统疾病，其特征为影响上、下呼吸道的坏死性肉芽肿性炎症、播散性血管炎和肾小球肾炎。据报道，WG口腔损害在6% - 13%的患者中出现；仅在2%的病例中为首发表现。本文报告一例以草莓样牙龈炎为WG首发体征的病例，该17岁男孩的上颌前部牙龈出现红斑及疼痛性局限性牙龈肿大。通过组织病理学与常规苏木精-伊红染色以及诸如格罗科特-戈莫里六胺银染色和过碘酸-希夫染色、外周血涂片、胸部X线片、结核菌素试验和临床表现的相关性来诊断这一罕见疾病。通过上述检查程序，我们确诊为WG。报告该病例的目的是强调，牙科医生常常是首个检查口腔的人，应熟悉“草莓样牙龈炎”这种牙龈的典型表现、其临床病程、诊断参数以及WG的恰当处理。
