GRANULOMATOSIS WITH POLYANGIITIS ASSOCIATED WITH THE PRESENCE OF ORAL ULCERATIONS AND STRAWBERRY GINGIVITIS.

Granulomatosis with polyangiitis (GPA) is defined as small- and medium-sized vessels vasculitis, compromising mainly upper and lower respiratory tract. Female patient, 17 years old, presented with oral ulcers of erythematous halo and central pseudomembrane in lower labial mucosa and tongue, with "strawberry gingivitis" in anterior maxillary and mandibular marginal gingiva. General evaluation reveled purpuric body lesions and fever. Image exams showed a lung mass, which was biopsied, and histopathological exam indicate GPA. For diagnosis of oral lesions, a biopsy was performed, with findings of epithelial hyperplasia, tissue necrosis, lympho-histiocyte inflammatory infiltrate with neutrophils and subepithelial microabscess formation. After histopathological analysis, clinical findings and positive results for cytoplasmic (c-ANCA-PR3) tests, the final diagnosis was confirmed. Therapy with rituximab, methylprednisolone and azathioprine led to regression of oral lesions. The presence of oral lesions with these characteristics are important for oral medicine clinicians, be aware about initial features of oral lesions in GPA. [ABSTRACT FROM AUTHOR]