Unusual Mouth and Nose Symptoms Reveal Rare and Serious Autoimmune Disorder Linked to COVID-19
Nikhil Prasad Fact checked by:Thailand Medical News Team Jun 03, 2025 2 weeks, 1 day, 14 hours, 50 minutes ago
Medical News: Doctors from Hospital Civil de Guadalajara ‘Fray Antonio Alcalde’ in Mexico have shared a striking case that adds to growing concerns over COVID-19’s ability to trigger serious autoimmune diseases. In this case, a 31-year-old woman developed a rare and potentially life-threatening disease called granulomatosis with polyangiitis (GPA) shortly after a mild bout of COVID-19.
Strawberry gingivitis.
GPA is a condition that causes inflammation and damage to blood vessels, mainly in the nose, lungs, and kidneys. What made this case especially alarming was how it began—with unusual symptoms like red, swollen gums and a hole forming in the nasal septum, the cartilage that separates the two nostrils.
This
Medical News report highlights how COVID-19 is not just a respiratory virus but may be a powerful trigger of autoimmune disorders that can affect the body in strange and severe ways.
A Strange Illness After Mild COVID
The woman had previously recovered from a mild case of COVID-19, confirmed by PCR testing. Just weeks later, she began experiencing constant fatigue, fever, facial pain, nasal bleeding, and bad-smelling discharge from her nose. Her gums turned red and swollen and had a bumpy texture, a condition doctors refer to as “strawberry gingivitis.” She also developed painful ulcers in her mouth and on her skin.
Imaging tests revealed that she had serious inflammation in her sinuses and a perforation (hole) in her nasal septum. This nasal damage is often seen in advanced GPA cases. Doctors also discovered she had skin ulcers and swelling in her face. Laboratory tests confirmed the presence of antibodies associated with GPA—specifically c-ANCA and anti-proteinase 3 antibodies.
Doctors diagnosed her with granulomatosis with polyangiitis and quickly started her on a combination of methylprednisolone (a steroid) and rituximab, a powerful drug that targets certain immune cells.
Improvement Followed by Facial Collapse
Within two weeks of treatment, the woman’s symptoms began to improve, but the swelling in her face receded to reveal a “saddle nose”—a collapse of the nasal bridge, which is a well-known complication of GPA caused by the destruction of nasal cartilage.
The case illustrates the importance of diagnosing GPA early, as delays can result in permanent facial disfigurement and damage to internal organs.
What Is Granulomatosis with Polyangiitis
GPA is a rare disease in which the immune system attacks blood vessels, leading to inflammation and damage in various parts of the body. It often begins in the upper airways, causing sinus infections, nasal bleeding, and facial swelling. If left untreated, it can progress to affect the lungs and kidneys, becoming life-threatening.
One of the unique clues that helped doctors in this case
was the presence of strawberry gingivitis—an uncommon but distinct sign of GPA that can be seen in the mouth before other symptoms become apparent. This highlights the importance of paying attention to oral health and seeking care when unusual symptoms occur.
Could COVID-19 Be the Trigger
Emerging evidence suggests that COVID-19 can act as a trigger for autoimmune diseases like GPA. While the exact mechanism is not fully understood, the virus is known to overstimulate the immune system, causing a “cytokine storm” and other immune abnormalities that may lead to the body mistakenly attacking its own tissues.
In individuals with a genetic tendency toward autoimmune conditions, a viral infection such as COVID-19 might be the final spark that sets off the disease.
Previous studies have reported similar cases of autoimmune disorders emerging after COVID-19, including lupus, rheumatoid arthritis, and vasculitis. This case adds further weight to those concerns, especially because the woman only had a mild form of COVID-19—showing that even less severe infections can have serious long-term consequences.
Importance of Early Treatment
Treatment with rituximab, an immunotherapy that depletes certain white blood cells, is now widely considered one of the best options for GPA. In this patient’s case, the quick use of this treatment helped control inflammation and halted disease progression, though not before permanent nasal damage occurred.
According to the researchers, prompt diagnosis and aggressive treatment are essential for preventing lasting damage and improving outcomes. They also stressed the importance of paying attention to oral and nasal symptoms as potential early warning signs of systemic diseases like GPA.
Conclusion
This rare and tragic case reminds us that COVID-19’s effects extend far beyond the lungs. For some people, especially those with an underlying genetic predisposition, the virus can trigger devastating autoimmune reactions. In this instance, what started as mild COVID-19 turned into a complex autoimmune disease that could have been fatal if not caught in time. The appearance of strawberry-like gums and facial pain served as crucial warning signs. This case also underscores how COVID-19 might be far from over in terms of the health risks it poses, especially regarding post-viral autoimmune complications.
The study findings were published in the peer reviewed journal: JEADV Clinical Practice.
https://onlinelibrary.wiley.com/doi/10.1002/jvc2.70066
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