Strawberry gum が診断の契機となった Wegener 肉芽腫症の1例 Strawberry gums as a diagnostic clue to Wegener's granulomatosis : A case report
Wegener's granulomatosis (WG) is a systemic disease characterized by necrotizing granulomatous inflammation of the respiratory tract, kidneys, and other organs. The most characteristic oral manifestation of WG is an unusual form of hyperplastic gingivitis. Because the clinical appearance of the affected gums resembles overripe strawberries, the gingivitis is referred to as "strawberry gums". We report a case of WG showing typical strawberry gums with middle ear and nasal involvement. A 43-year-old woman was referred to our department because of gingival swelling after an operation for otitis media, which had not been diagnosed as WG at that time. The gingival surface appeared granular, resembling over-ripe strawberries. A gingival biopsy specimen showed microabscesses and multinucleate giant cells, characteristic findings of strawberry gums. The clinical appearance and histopathological findings suggested a diagnosis of WG. The diagnosis was supported by a positive anti-neutrophil cytoplasmic antibody test (cANCA). The patient responded to treatment with steroids and immunosuppressants, and the strawberry gums disappeared. The typical findings of strawberry gums were the initial diagnostic sign of WG.
日本口腔外科学会雑誌 50(9), 550-553, 2004-09-20
Japanese Society of Oral and Maxillofacial Surgeons