History: A 14 year-old girl was referred to a periodontist because of sore gums and loose teeth.. The patient had also experienced regular episodes of fever, ear infections, skin rash and enlargements of cervical lymph nodes. These episodes occurred approximately every three weeks.

Clinical: The gingival tissues showed generalized hypertrophy, erythema and bleed on gentle probing. A considerable degree of gingival recession was noted, particularly the lower central incisors. The patient stated that at periodic intervals the gums were more sore and the teeth more loose.

Radiographic Features: Radiographic examination revealed generalized alveolar destruction suggestive of moderate periodontitis.