Recurrence of Wegener's granulomatosis with de novo intraoral presentation treated successfully with rituximab.
We describe a unique case of a recurrence of Wegener's granulomatosis (WG) that presented with oral pain involving a left maxillary molar, which thereafter led to an extraction. Oral lesions with a classical appearance of strawberry gingivitis developed following the extraction. The primary disease did not have any oral manifestations. Both the primary disease and recurrence responded to rituximab, a monoclonal B-cell depleting antibody. Rituximab is emerging as a drug with significant potential to improve treatment of primary and, as described in this case, recurrent WG.
Staines
Konrad S
KS
Newcastle Dental Hospital & School, Newcastle upon Tyne, UK. konrad.staines@nuth.nhs.uk
Higgins
Bernard
B
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000175:diagnosis / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D000069283:Rituximab; D014081:Tooth Extraction; D014098:Toothache / Q000628:therapy
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D005938:Glucocorticoids; D007155:Immunologic Factors; D000069283:Rituximab; D011239:Prednisolone