Skip to main content Skip to main navigation menu Skip to site footer

Strawberry gingivitis as the first sign of wegener’s granulomatosis: a case report


Objective: To describe that Wegener’s granulomatosis (WG) is an autoim­mune multisystem disease with unknown etiolo­gy, characterized by the classic triad of necrotizing granulomas affecting the upper and lower respiratory tracts, disseminated vasculitis and glomerulonephritis. WG can affect any organ including kidneys, eyes or other organs. Oral involvement, like strawberry gingivitis, is an important sign of this disease even though it is rare.Methods: A 19 years old female was referred to oral medicine clinic with the chief complaint swelling on the gingiva which was increasing widespread. Since one month before the gingival enlargement did not respond to antibiotic.  Intraoral examination, showed gingival enlargement at the upper anterior, palate, and first left mandibular molar. The swollen tissue was characterized by its granularity, short bulbous projections and bright red colour. The gingival appearance mimicking an overripe strawberry and extra oral examination showed cutaneous vasculitis at the hands and feet.  Laboratory evaluation presented erythrocyte sedimentation rate, CRP and eGFR (modified MORD) were elevated but the urinalysis was within normal ranges. Based on the anamnesis, clinical and laboratory examination, WG diagnosis was made. The patient was treated with oral corticosteroids and chlorhexidine gluconate 0.1% mouthwash.Results: The gingival inflammation improved after one month therapy and the patient still being followed-up at reguler time. Conclusions: Early detection of oral manifestation of WG is important for dentists, especially oral medicine specialist, in order to achieve adequate treatment and preventing systemic tissue or organ damage.


  1. Aravena V, Beltrán V, Fuentes R, et al. Gingival hyperplasia being the first sign of Wegener’s granulomatosis. Int J Clin Exp Med 2014;7: 2373-2376.
  2. Rashed M, Mozaffari PM, Javadzadeh A, et al. Wegener granulomatosis with oral involvement as primary manifestation : a case study. JDMT 2017;6: 89-96.
  3. Yi ES, Colby TV. Wegener’s granulomatosis. Semin Diagn Pathol 2001;18: 34-46.
  4. George J, Levy Y, Kallenberg CG, et al. Infections and Wegener’s granulomatosis cause and effect relationship. QJM 1997;90: 367-373.
  5. Grahne B, Zechner G. Wegener’s granulomatosis. Acta Otolaryngol 1966;62: 362-372.
  6. Siar CH, Yeo KBKNHN, Tsujigiwa H, et al. Strawberry gingivitis as the first presenting sign of Wegener’s granulomatosis: report of a case. Eur J Med Res 2011;16: 331-334.
  7. Almouhawis HA, Leao JC, Fedele S, et al. Wegener’s granulomatosis: a review of clinical features and an update in diagnosis and treatment. J Oral Pathol Med 2013;42: 507-516.
  8. Manchanda Y, Tejasvi T, Handa R, et al. Strawberry gingiva: a distinctive sign in Wegener’s granulomatosis. J Am Acad Dermatol 2003;49: 335-337.
  9. Marzano AV, Balice Y, Papini M, et al. Localized Wegener’s granulomatosis. J Eur Acad Dermatol Venereol 2011;25: 1466-1470.
  10. Lourenço SV, Nico MMS. Strawberry gingivitis: An isolated manifestation of Wegener’s granulomatosis. Acta Derm Venereol 2006;86: 90-91.
  11. Comarmond C, Cacoub P. Granulomatosis with polyangiitis (Wegener): clinical aspects and treatment. Autoimmun Rev 2010;13: 1121-1125.
  12. Guidelli GM, Tenti S, Pascarelli NA, et al. Granulomatosis with polyangiitis and intravenous immunoglobulins: a case series and review of the literature. Autoimmun Rev 2015;14: 659-664.
  13. Agrawal AA. Gingival enlargements: differential diagnosis and review of literature. World J Clin Cases 2015;3: 779.
  14. Hiz F, Cinar M, Karagol T, et al. Wegener’s granulomatosis: case report. The Internet J Neurol 2007; 6.
  15. Hoffman GS. Wegener’s granulomatosis. Curr Opin Rheumatol 1993;5: 11-17.
  16. Muryah AE, Sufiawati I. Successful treatment of herpes simplex-associated erythema multiforme with a combination of acyclovir and prednisone. J Dentomaxillofacial Sci 2017;2: 191-193.
  17. Cotch MF, Hoffman GS, Yerg DE, et al. The epidemiology of Wegener’s granulomatosis. Estimates of the five year period prevalence, annual mortality and geographic disease distribution from population-based data sources. Arthritis Rheum 1996;39: 87-92.

How to Cite

Tamigoes, Y., & Setiadhi, R. (2019). Strawberry gingivitis as the first sign of wegener’s granulomatosis: a case report. Journal of Dentomaxillofacial Science, 4(1), 51–54.




Search Panel