Diagnosing severe gingival swelling with nasal involvement, inflammatory markers

Researchers examined the potential diagnosis of a 69-year-old female patient with gingival swelling.

In a study published in JAMA Otolaryngology-Head & Neck Surgery, the researchers detailed that the patient presented with widespread gingival swelling that had progressed over a period of three months and was resistant to antibiotic treatment. She experienced a low-grade fever, malaise, loss of appetite, weight loss and epistaxis.

After conducting a gingival biopsy, the researchers noted chronic inflammation, microabscess foci and pseudoepitheliomatous hyperplasia of the covering epithelium. Laboratory results revealed neutrophilic leukocytosis, anemia, elevated inflammatory markers and hypergammaglobulinemia. The patient also had lung nodules.

The researchers diagnosed the patient with granulomatosis with polyangiitis, a type of small- to medium-vessel vasculitis characterized by necrotizing granulomatosis inflammation of the respiratory tract.

After treatment with corticosteroids, the patient experienced rapid improvement.

Read more: JAMA Otolaryngology-Head & Neck Surgery

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