Wegener's Granulomatosis Presenting as a Diffuse Palatal Swelling, a Rare Presentation: Case Report

Wegener's granulomatosis (WG) is an uncommon idiopathic, systemic inflammatory disease which is characterized by necrotizing granulomatous inflammation and pauci-immune small vessel vasculitis of the kidneys and respiratory tract resulting in significant tissue destruction. The clinical features are generally non-specific thereby posing a diagnostic challenge. Oralmanifestations of the disease are rare and again nonspecific. Oral ulceration and gingivalenlargement is often seen. Though some authors suggest a ‘strawberry’ like gingivitis to be acharacteristic sign of WG, it is not consistently seen in all cases. Histopathological evaluation of the lesion showing granulomatous inflammation may not be pathognomonic but helps inexclusion of other diseases but in conjunction with a positive anti-neutrophil cytoplasmic antibodies (ANCA) test confirms the diagnosis. The disease is not curable and hencetreatment is aimed at inducing and sustaining remission. Glucocorticoids with other immunosuppressants are the most accepted form of therapy.