Giant cell arteritis affecting the tongue: a case report and review of the literature

Grant, S.; Underhill, Helen C; Atkin, Philip A.

doi:10.12968/denu.2013.40.8.669

Cited by 22 publications

(13 citation statements)

References 27 publications

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“…In our case the lack of appropriately sized vessels in the biopsy unabled the pathologist to rule out temporal arteritis as a possible cause when reexamining the biopsies. Unlike patients suffering from vasculitis our patient did not present the classical symptoms of vasculitis and experienced complete remission without corticosteroid treatment [1,2,[6][7][8] . The pathological diagnosis is paramount in choosing the correct treatment of a patient with an ulcerous necrosis of the tongue.…”

Section: Discussionmentioning

confidence: 59%

“…The most important differential diagnosis is vasculitis, which is known to be associated with an increased risk of thrombosis [5] . Giant cell arteritis (GCA) represents the most common systemic vasculitis and is known to cause necrosis of the tongue in some patients [6][7][8][9] . Typical GCA symptoms are headache, scalp tenderness, jaw claudication and in some cases also acute visual loss.…”

Section: Introductionmentioning

confidence: 99%

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Lingual thrombosis presenting as tongue carcinoma

Arndal¹,

Barfoed²,

Rasmussen³

2014

CRCP

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We report a case of a 57-year old man who was admitted to our department with a necrotic ulcer of the tongue. Carcinoma of the tongue was initially suspected and incisional biopsies were performed along with Magnetic Resonance Imaging of the head and neck and a Computerized Tomography of the head, neck and thorax. The images were normal and the biopsies surprisingly did not show malignancy but venous thrombosis. The patient experienced complete remission without treatment. When re-examining the biopsies the pathologist was unable to rule out vasculitis as a possible cause, because the specimen lacked the appropriate sized vessels for diagnostics. We would like to emphasize that vasculitis should always be considered as a differential diagnosis, when biopsies turn out non-malignant in a patient with a necrotic ulcer of the tongue.

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Section: Discussionmentioning

confidence: 59%

Section: Introductionmentioning

confidence: 99%

Lingual thrombosis presenting as tongue carcinoma

Arndal¹,

Barfoed²,

Rasmussen³

2014

CRCP

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“…D'autres manifestations oro-faciales (trismus, dysphagie, dysarthrie, hypoesthésie de la joue, macroglossie, oedème facial, tuméfaction submandibulaire…) ont été décrites de façon sporadique dans la littérature [7]. Les manifestations intra-buccales de l'ACG, liées à l'atteinte des artères linguale et maxillaire, comportent des douleurs/brûlures buccales, une pâleur des muqueuses, une claudication de la langue et des ulcérations nécrotiques, notamment à localisation linguale, pelvienne buccale et labiale [6,9,12,13].…”

Section: Fig 4a Histological Analysis Of the Right Temporal Artery unclassified

“…Dans le cas rapporté, dès la consultation de chirurgie buccale, la patiente réunissait 3 des 5 critères et présentait tous les élé-ments diagnostiques à l'issue de la consultation de rhumatologie. La biopsie de l'artère temporale superficielle est le gold standard du diagnostic mais elle est faussement négative dans 10 à 25 % des cas [13,22]. L'imagerie des artères atteintes est un outil diagnostique efficace, notamment l'écho-doppler quand il permet de mettre en évidence le signe du halo péri-vasculaire hyperéchogène traduisant l'épaississement de la paroi (sensibilité de 69 % et spécificité de 82 %) [23].…”

Section: Fig 4b Histological Analysis Of the Right Temporal Artery unclassified

Manifestations atypiques de l’artérite à cellules géantes : un défi pour le chirurgien-dentiste. Cas clinique et revue de la littérature

Radoï

Renoux

2016

Med Buccale Chir Buccale

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Résumé -Introduction : L'artérite à cellules géantes (ACG) est une pathologie inflammatoire chronique vasculaire affectant le patient à partir de la 5 ème décennie. Le tableau clinique, très varié et parfois atypique, peut induire des erreurs diagnostiques avec de lourdes conséquences. Observation : Une patiente de 63 ans s'était présentée à la consultation de chirurgie buccale après une errance diagnostique pour des douleurs cervicales postérieures et occipitales, irradiant ensuite au maxillaire droit, interprétées initialement comme d'origine dentaire. Le tableau clinique, réétudié lors de la consultation, montrait des modifications de l'artère temporale superficielle faisant suspecter une ACG. La patiente fut directement orientée vers le service de rhumatologie pour la confirmation du diagnostic et la prise en charge immédiate. Discussion : Les manifestations de l'ACG sont le reflet de l'atteinte de nombreuses artères issues de l'arc aortique, responsable de tableaux cliniques très variés. Les conséquences graves à court terme de cette affection (cécité irréversible, accident vasculaire cérébral) imposent une prise en charge urgente et efficace par une corticothérapie systémique. Conclusion : La diversité des manifestations de l'ACG peut conduire le patient à consulter en premier lieu le chirurgien-dentiste qui doit savoir inclure cette pathologie dans les diagnostics différentiels des douleurs oro-faciales et adresser rapidement le patient. Abstract -Atypical manifestations of giant cell arteritis: Case report and literature review. Introduction:Giant cell arteritis (GCA) is a vasculitis commonly affecting patients after the fifth decade. Atypical clinical manifestations can induce a wrong diagnosis that can lead to dramatic damages. Observation: A 63-year-old woman had been sent to oral surgery department for maxillary pain, after being seen by a dentist and an endodontist: a dental origin had wrongly been suspected. Besides several symptoms (orofacial pain, asthenia, anorexia), clinical abnormalities of the right temporal artery evoked the diagnosis of GCA. She had been sent quickly to the rheumatology service for confirmation of the diagnosis and special care. Discussion: Inflammation of branches of aortic artery lead to several clinical manifestations, resulting sometimes in atypical expressions. The potentially severe consequences of the disease (irreversible blindness, ischemic stroke) compel an immediate corticosteroid therapy. Conclusion: The large variety of clinical manifestations of the GCA has to be known by the dental surgeon, to be able to identify atypical symptoms and to send his patient as soon as possible to the specialist.

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“…Early diagnosis is vital in order to avoid complications, such as symptoms of ischemia [5, 6]. In some patients, however, unusual symptoms, such as lingual necrosis may appear as an initial manifestation, thus hindering diagnosis [7–9].…”

Section: Introductionmentioning

confidence: 99%

Tongue Necrosis Secondary to Giant Cell Arteritis: A Case Report and Literature Review

Sobrinho

Lima

Moura

et al. 2017

Case Reports in Medicine

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Giant cell arteritis is a form of vasculitis involving the medium- and large-sized arteries that chiefly affects older people. Clinical findings are headache, jaw claudication, fever, pain, and thickening of the temporal artery. The most feared complication is visual loss due to impairment of the ophthalmic artery and posterior ciliary arteries. This a case report of an 85-year-old male presenting with headache and jaw pain, who was admitted with tongue necrosis as an initial manifestation of giant cell arteritis. The necrotic area detached spontaneously after two weeks of therapy with corticosteroids and methotrexate. Reviewing the literature, our patient presented with clinical symptoms consistent with most reports, except for the fact of being male. Although unusual as an initial manifestation, tongue necrosis is an important alert for diagnosing giant cell arteritis. Early diagnosis and treatment of this atypical manifestation may reduce morbidity.

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Giant cell arteritis affecting the tongue: a case report and review of the literature

Abstract: Dental clinicians may play a part in the early diagnosis of GCA by having a high index of suspicion for its symptoms in patients, so that devastating ischaemic consequences, such as irreversible visual loss, can be prevented.

Cited by 22 publications

References 27 publications

Lingual thrombosis presenting as tongue carcinoma

Lingual thrombosis presenting as tongue carcinoma

Manifestations atypiques de l’artérite à cellules géantes : un défi pour le chirurgien-dentiste. Cas clinique et revue de la littérature

Tongue Necrosis Secondary to Giant Cell Arteritis: A Case Report and Literature Review

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