Granulomatosis with Polyangitis: Rare Cause of Oral Ulcer in Paediatric Patient

Granulomatosis with Polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is part of a vast spectrum of diseases entitled Anti-Neutrophil Cytoplasmic Antibodies (ANCA)-associated vasculitides. It predominantly presents in adults and is associated with necrotising vasculitis, primarily affecting small to medium vessels. An oral ulcer is one among the myriad clinical presentations of GPA. A long-standing solitary oral ulcer of the oral mucosa can also be the clinical presentation of many different diseases and always poses a significant diagnostic challenge. Appropriate clinical and investigative work-up is required to reach the correct diagnosis. Timely intervention and management are also important in reducing the morbidity and mortality associated with such conditions. Hereby, the authors presents a case of a 13-year-old female patient who complained of a solitary ulcer in the mouth. Additionally, she had a history of recurrent nasal ulcers and epistaxis but did not report any other symptoms. Clinical examination showed nasal ulcers, a solitary ulceroproliferative lesion in the maxillary region and strawberry gingivitis. A systematic investigative work-up was conducted to reach the correct diagnosis and the condition was well-managed with appropriate immunosuppressive therapy.