title: Role of gingival manifestation in diagnosis of granulomatosis with polyangiitis (Wegener's granulomatosis).
abstract: OBJECTIVE
  This report describes a case of granulomatosis with polyangiitis (GPA) in which the gingival manifestation was crucial in both making an early diagnosis and possibly in deciding the approach to treatment.
  
  
  METHODS
  A 57-year-old sailor presented to the Department of Dentistry at Ulsan University Hospital complaining of gingival swelling since approximately 2 months. He had orofacial granulomatous lesions and the specific gingival manifestation of strawberry gingivitis.
  
  
  RESULTS
  The diagnosis of GPA was made on the basis of clinical symptoms and signs, and confirmed by the presence of the anti-neutrophil cytoplasmic antibody and a positive biopsy. The patient was admitted to the hospital and subsequently placed on a disease-modifying therapy regimen that included methotrexate and prednisone.
  
  
  CONCLUSIONS
  Identification of the gingival manifestation of the disease permitted an early diagnosis and prompt therapy in a disease in which time is a crucial factor. Because of its rapid progression and potentially fatal outcome, an early diagnosis of GPA is important. Therefore, dentists should be aware of the oral signs and symptoms of such systemic diseases.
authors.affiliation: Department of Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea .
authors.forename: Iel-Yong
authors.identifier: 0000-0002-9235-971X
authors.initials: IY
authors.lastname: Sung
authors.affiliation: Department of Pathology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea .
authors.forename: Young-Min
authors.identifier: 0000-0001-8266-4553
authors.initials: YM
authors.lastname: Kim
authors.affiliation: Department of Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea .
authors.forename: Yeong-Cheol
authors.identifier: 0000-0003-3891-218X
authors.initials: YC
authors.lastname: Cho
authors.affiliation: Department of Dentistry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea .
authors.forename: Jang-Ho
authors.identifier: 0000-0002-9681-3561
authors.initials: JH
authors.lastname: Son
keywords: Diagnosis; Gingiva; Granulomatosis with polyangiitis; Orofacial