Wegener's granulomatosis: Report of three cases with oral lesions

Abstract In 1936 and 1939, Friederich Wegener published descriptions of the clinical and autopsy findings of several patients who exhibited necrotizing granulomatous inflammation of small- to medium-sized blood vessels, with similar destructive infiltrates in the respiratory tract and kidneys. 1,2 Wegener's granulomatosis (WG) has since become a well-recognized disease the etiology of which remains obscure; many investigators believe that an immunologic pathogenesis is likely. 3 The prognosis for untreated WG is poor, with most deaths resulting from renal failure secondary to glomerulonephritis. 4 A much better prognosis is associated with the limited form of WG, which has respiratory, but not renal, involvement. 5 In addition, a superficial form of WG has been described, manifesting as lesions that are confined to cutaneous or mucosal surfaces, that has an even better prognosis. 6 Each of these forms of WG may present with oral lesions as an initial manifestation of the disease 7 ; thus, prompt recognition by the clinician may lead to an earlier diagnosis and proper management. The purpose of this article is to describe the clinical and microscopic findings of the oral lesions of WG in three patients who each presented with a different form of the condition.