Recurrence of Wegener's granulomatosis with de novo intraoral presentation treated successfully with rituximab

We describe a unique case of a recurrence of Wegener's granulomatosis (WG) that presented with oral pain involving a left maxillary molar, which thereafter led to an extraction. Oral lesions with a classical appearance of strawberry gingivitis developed following the extraction. The primary disease did not have any oral manifestations. Both the primary disease and recurrence responded to rituximab, a monoclonal B-cell depleting antibody. Rituximab is emerging as a drug with significant potential to improve treatment of primary and, as described in this case, recurrent WG.