Strawberry Gingivitis as a Diagnostic Clue to Granulomatosis With Polyangiitis in an Older Woman: A Case Report

BACKGROUND: Strawberry gingivitis is a characteristic but under-recognised oral manifestation of granulomatosis with polyangiitis (GPA), with potential for long-term sensory damage often overlooked. CASE PRESENTATION: A 60-year-old woman with strawberry gingivitis, cough, and hearing loss fulfilled the 2022 ACR/EULAR classification criteria for GPA (score 13), with the diagnosis established through integrated clinical, serological, radiological, and histopathological assessment. Induction therapy resolved the oral lesions, but 18-month follow-up showed bilateral deafness and blindness. CONCLUSIONS: Strawberry gingivitis is a highly characteristic, though not pathognomonic, sign of GPA. Even with good short-term control, patients risk progressive sensory damage, emphasising the need for long-term follow-up.