Ultrastructural findings and clinical follow-up of 'strawberry gums' in Wegener's granulomatosis.

Gingival changes in one patient with Wegener's granulomatosis were followed up for one year. A strawberry appearance was present in the marginal gingiva regardless of very effective periodontal treatment. Light microscopy showed acute vasculitis and an inflammatory infiltration containing mainly plasma cells and eosinophilic and neutrophilic granulocytes. The diagnosis of necrotizing vasculitis was confirmed by electron microscopy. Intravascular lysis of cells with aggregation of platelets seemed to be important in the pathogenesis of the vasculitis. The results emphasize the importance of a gingival biopsy, alongside lung and renal biopsies, as an aid in the primary diagnosis of Wegener's granulomatosis.