Strawberry Gingivitis of Wegener’s Granulomatosis: A Clinico-pathological and Immunohistochemical Case Study with Review of Literature

Abstract

This paper discusses strawberry gingivitis of Wegener granulomatosis clinically, histologically and immunohistochemically. The reported case is compared to similar cases in the medical literature. Strawberry gingivitis is neither initially indicative for WG nor pathognomonic for it because it is evident in other fungal and carcinomatous conditions. However, this oral lesion, if clinically evident, can establish abundant information about the nature of the disease. The tested immunohistochemical markers (IHCMs) that are used in this study are Cathepsin K , and Myeloblastin (PR3). These two IHCMs proved to be strongly positive in WG. This histochemical profile can be useful in establishing the diagnosis of WG from a small friable gingival tissue. Accordingly, this paper describes and recommends a suggested protocol of diagnosing Wegener’s granulomatosis from a gingival lesional tissue. The superiority of this protocol banks mainly on simplicity, availability and fidelity of the involved procedures. Still, testing the gingival tissue would be informative and useful, unlike Anti-neutrophil cytoplasmic antibody (ANCA) test, if “strawberry gingivitis” was a manifestation of either fungal or carcinomatous conditions.