Subtotal tongue necrosis in delayed diagnosed giant-cell arteritis: A case report

Giant-cell arteritis (GCA) is a chronic systemic vasculitis of large- and medium-sized vessels, mainly affecting elderly patients. Headache, vision impairment, jaw claudication, and scalp tenderness are common symptoms. However, diagnosis can be difficult because GCA can affect almost every vascular...

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Bibliographic Details
Published in:American journal of otolaryngology 2004-11, Vol.25 (6), p.438-441
Main Authors: Biebl, Matthias Oliver, Hugl, Beate, Posch, Lydia, Tzankov, Alexandar, Weber, Florian, Perkmann, Reinhold, Fraedrich, Gustav
Format: Article
Language:English
Subjects:
Aged
Azathioprine - therapeutic use
Biological and medical sciences
Female
Giant Cell Arteritis - diagnosis
Giant Cell Arteritis - drug therapy
Giant Cell Arteritis - pathology
Humans
Immunosuppressive Agents - therapeutic use
Medical sciences
Necrosis
Otorhinolaryngology. Stomatology
Prednisolone - therapeutic use
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Tongue - pathology
Vision Disorders - etiology
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Summary:Giant-cell arteritis (GCA) is a chronic systemic vasculitis of large- and medium-sized vessels, mainly affecting elderly patients. Headache, vision impairment, jaw claudication, and scalp tenderness are common symptoms. However, diagnosis can be difficult because GCA can affect almost every vascular pathway and lead to a variety of possible manifestations. We report the case of a belated diagnosed GCA, resulting in nearly complete necrosis of the mobile part of the tongue, visual impairment, and neurologic as well as intestinal ischemic symptoms. Aggressive immunosuppressive treatment resolved the symptoms, but the patient remained severely morbid because of bilateral necrosis of the mobile part of the tongue. In any case of unclear ischemic symptoms in an elderly patient, one must keep GCA in mind as the possible culprit disease.
ISSN:0196-0709
1532-818X
DOI:10.1016/j.amjoto.2004.06.004