{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T20:52:09Z","timestamp":1781988729993,"version":"3.54.5"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Dentistry"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Granulomatosis with polyangiitis (GPA), formerly known as Wegener\u2032s granulomatosis, is a rare, systemic small\u2010vessel vasculitis characterized by necrotizing granulomatous inflammation. It classically affects the upper airway, lungs, and kidneys. Oral manifestations are infrequent, occurring in approximately 6%\u201313% of cases, and represent the initial presentation in only about 2%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 55\u2010year\u2010old female was presented with a two\u2010month history of painful, bleeding gingival hyperplasia unresponsive to routine periodontal therapy. Intraoral exam revealed \u201cstrawberry gingivitis\u201d\u2014diffuse, friable, erythematous granular gingival enlargement. Comprehensive workup showed elevated inflammatory markers and positive cytoplasmic ANCA (c\u2010ANCA). Gingival biopsy demonstrated granulomatous inflammation with necrotizing vasculitis, confirming localized GPA confined to oral tissues. Multidisciplinary management was initiated with systemic immunosuppression (oral azathioprine and deflazacort) and topical therapy, alongside optimization of the patient\u2019s comorbid conditions. An antifungal and antibiotic prophylaxis regimen was also provided.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Following the commencement of therapy, the gingival lesions exhibited complete resolution within 3 weeks. Over a 12\u2010month follow\u2010up period, there was no evidence of progression to other organ involvement. The concurrent management of the patient\u2032s diabetes and hypothyroidism was instrumental in facilitating optimal healing and overall patient recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case distinctly underscores that GPA can present solely with oral symptoms, making early recognition by dental clinicians paramount for prompt diagnosis. The presence of \u201cstrawberry gingivitis\u201d serves as a crucial, pathognomonic clinical sign. We propose a diagnostic and management protocol for oral GPA to improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crid\/8443058","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T08:37:47Z","timestamp":1768984667000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Refractory Gingival Enlargement: A Critical Oral Clue to Early\u2010Stage Granulomatosis With Polyangiitis\u2014A Case Report and Literature Review"],"prefix":"10.1155","volume":"2026","author":[{"given":"Sarwer","family":"Biplob","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2745-6652","authenticated-orcid":false,"given":"Rahmi","family":"Amtha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najla","family":"Nadiah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachendra","family":"Pratama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.4103\/jomfp.JOMFP_3_19"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/jomfp.jomfp_92_22"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.706"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/jiaomr.jiaomr_320_23"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.xocr.2018.05.002"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/2047-783X-16-7-331"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-020-01144-0"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.5582\/irdr.2022.01045"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-0008"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jds.2018.10.004"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/jop.13008"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5534851"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2018.09.002"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-016-0262-4"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000336185"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.06.003"}],"container-title":["Case Reports in Dentistry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crid\/8443058","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crid\/8443058","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crid\/8443058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T20:46:20Z","timestamp":1781988380000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crid\/8443058"}},"subtitle":[],"editor":[{"given":"Tommaso","family":"Lombardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crid\/8443058"],"URL":"https:\/\/doi.org\/10.1155\/crid\/8443058","archive":["Portico"],"relation":{},"ISSN":["2090-6447","2090-6455"],"issn-type":[{"value":"2090-6447","type":"print"},{"value":"2090-6455","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8443058"}}