Multiple oral ulcerations: A very rare case of Churg-Strauss syndrome with renal disease

Oral ulcerations are an extremely rare manifestation of Churg-Strauss Syndrome (CSS), which have not yet been documented as a potential prodromal sign of this multisystemic autoimmune vasculitis which may also involve the kidneys. The authors present a very rare case report of widespread oral ulcerations which preceded the onset of CSS with crescentic glomerulonephritis and persisted throughout the course of the disease. Oral manifestations included atypical clusters of oral aphthae and other lingual and mucosal ulcerations. The case demonstrates the disease spectrum and review of current understanding of this disease. The dentist may be the first health care professional to see patients with symptoms and findings of this condition. Definitive diagnosis is challenging owing to the subtle onset of the disease and variable clinical and laboratory findings. Clinicians should be informed about the possibility of oral manifestations of CSS to facilitate prompt disease recognition and to provide continued oral health care to these medically complex patients. Early diagnosis and treatment is the most important factor in the management of this potentially fatal disease as well as to promote quicker remission.