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A 12 year old boy presented via his orthodontist with a three month history of facial swelling and a one year history of intermittent diarrhoea. Examination revealed a pale boy with asymmetrical thickening of his cheeks, a buccal mucosal fold on the left, and friable mucosa on the right. Investigations revealed a mild hypochromic microcytic anaemia and raised inflammatory markers.
An oral biopsy showed occasional granulomata and a mixed inflammatory infiltrate with negative fungal stains consistent with a diagnosis of orofacial granulomatosis. 99Tcm-HMPAO leucocyte scintigraphy showed grade 3 white cell activity in the terminal ileum …
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