An oral examination revealed gingival hyperplasia with a granular and hemorrhagic appearance typical of “strawberry gingivitis.” Laboratory test results showed an elevated titer of antineutrophil cytoplasmic antibodies with a cytoplasmic staining pattern (c-ANCA), and an enzyme-linked immunosorbent assay for anti–proteinase 3 antibodies was positive. #Clinical #IM #Rheum #GPA #GranulomatosisWithPolyangiitis #Wegeners #Strawberry #StrawberryGingivitis #GingivalHyperplasia #NEJM