Granulomatosis with polyangiitis diagnosed with strawberry gums as the first symptom：A case report

Abstract

Granulomatosis with polyangiitis (GPA) is a rare multi-system disease characterized by necrotic and granulomatous changes of the respiratory tract, kidneys, and other organs. The most common initial symptom of this disease is necrotizing granuloma in the nasal and paranasal cavity, and oral lesions are rare. Strawberry gums is an oral lesion and a characteristic sign of GPA. While this feature is rare, it is characteristic and can serve as a clinical indicator of disease occurrence. We herein report a case of strawberry gums as the first presenting sign of GPA. The patient was a 24-year-old woman who was referred to our hospital because of gingival pain. The gingival surface appeared granular, resembling an over-ripe strawberry. Based on the clinical, laboratory, imaging, and histopathological findings, a diagnosis of GPA was made. The patient responded very well to treatment with steroids and immunosuppressants, and the strawberry gums disappeared. The diagnosis was established based on the finding of strawberry gums.