Granulomatosis with polyangiitis (Wegener’s) as a necrotizing gingivitis mimic: a case report

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dc.contributor.author Genuis, Katrina
dc.contributor.author Pewarchuk, Jesse
dc.date.accessioned 2015-05-04T21:14:19Z
dc.date.available 2015-05-04T21:14:19Z
dc.date.copyright 2014 en_US
dc.date.issued 2014-09-07
dc.identifier.citation Genuis and Pewarchuk: Granulomatosis with polyangiitis (Wegener’s) as a necrotizing gingivitis mimic: a case report. Journal of Medical Case Reports 2014 8:297 en_US
dc.identifier.uri http://www.jmedicalcasereports.com/content/8/1/297
dc.identifier.uri http://dx.doi.org/10.1186/1752-1947-8-297
dc.identifier.uri http://hdl.handle.net/1828/6132
dc.description BioMed Central en_US
dc.description.abstract Introduction: Granulomatosis with polyangiitis poses a significant diagnostic dilemma due its diverse presentations. Seemly isolated sites of disease, such as oral ulcers, may present to physicians working in primary care settings, the emergency room, and subspecialty fields as well as to dentists. Oral presentations are particularly challenging to identify and require a high index of suspicion and a detailed knowledge of the condition in order to diagnose and treat. We detail a case of granulomatosis with polyangiitis presenting as necrotizing gingivitis, one of the first of its kind to be reported. Case presentation: An otherwise healthy 32-year-old, Caucasian woman presented to various physicians with progressive, painful oral ulcers. Following consultations with multiple primary care physicians and subspecialties, an initial diagnosis of severe infectious necrotizing gingivitis was made resulting in combination antibiotic treatment as well as surgical debridement involving extraction of all maxillary and three mandibular teeth. With the discovery of a positive cytoplasmic anti-neutrophil cytoplasmic antibody and a constellation of associated systemic symptoms, our patient was subsequently diagnosed with granulomatosis with polyangiitis. The treatment regimen of rituximab and methylprednisone was chosen in consideration of our patient’s desire for future fertility and has been successful in inducing and maintaining remission. Conclusions: Following the case presentation, we review the current literature regarding granulomatosis with polyangiitis presentation, diagnosis and treatment. In discussing features of granulomatosis with polyangiitis presentation, diagnostic tests, and important new treatment options, we seek to enable physicians of all specialties to better recognize and begin appropriate treatment for this complex condition. en_US
dc.description.sponsorship Thanks are extended to the UBC Faculty of Medicine Dean’s Office and Medical Undergraduate Society for providing publication funding. en_US
dc.language.iso en en_US
dc.publisher Journal of Medical Case Reports en_US
dc.rights.uri An error occurred getting the license - uri. *
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/2.5/ca/ *
dc.subject Granulomatosis with polyangiitis en_US
dc.subject Wegener’s en_US
dc.subject Necrotizing gingivitis en_US
dc.subject ANCA en_US
dc.subject Rituximab en_US
dc.title Granulomatosis with polyangiitis (Wegener’s) as a necrotizing gingivitis mimic: a case report en_US
dc.type Article en_US
dc.rights.temp An error occurred on the license name. *
dc.rights.temp Attribution-NonCommercial-NoDerivs 2.5 Canada *
dc.description.scholarlevel Faculty en_US
dc.description.reviewstatus Reviewed en_US

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