Giant Cell Arteritis Presenting with a Tongue Lesion

Cockey, George; Shah, Syed Raza; Hampton, Troy

doi:10.1016/j.amjmed.2018.12.026

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Beyond ocular involvement, our patient exhibited lingual artery affection, as evidenced by tongue necrosis, which is an exceedingly rare manifestation of GCA. Tongue necrosis has been reported in fewer than 70 cases over the past five decades, further highlighting its rarity [ 5 ]. Bilateral lingual artery necrosis, as observed in our patient, is an even more exceptional finding, with only a handful of cases reported in the literature [ 5 - 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Tongue necrosis has been reported in fewer than 70 cases over the past five decades, further highlighting its rarity [ 5 ]. Bilateral lingual artery necrosis, as observed in our patient, is an even more exceptional finding, with only a handful of cases reported in the literature [ 5 - 8 ]. This severe ischemic insult to the tongue necessitates urgent evaluation and treatment to prevent further complications and associated morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Giant Cell Arteritis With Bilateral Central Retinal Artery Occlusion and Tongue Necrosis

Brar,

Nanda,

Narayanan

et al. 2024

Cureus

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This case report describes a complicated case of giant cell arteritis (GCA) with tongue necrosis and bilateral central retinal artery occlusion (CRAO). An 81-year-old male patient with a history of recent retinal artery occlusion, ischemic stroke, and hypertensive emergency was evaluated. Clinical examination, including a visual acuity assessment, fundus evaluation, and oral examination, was performed. Laboratory investigations, such as erythrocyte sedimentation rate (ESR), were conducted. A temporal artery biopsy was performed to confirm the diagnosis of GCA. The patient presented with sudden vision loss in the left eye following a prior episode of retinal artery occlusion in the right eye. Ophthalmoscopic examination revealed CRAO in the left eye. Additionally, tongue necrosis, a rare manifestation of GCA, was observed. The ESR was significantly elevated. A temporal artery biopsy supported the diagnosis of GCA. The patient was promptly referred for immunologist consultation and initiated on intravenous methylprednisolone therapy. This case highlights the diverse and potentially devastating nature of GCA, involving ocular and systemic manifestations. Bilateral CRAO and tongue necrosis are rare but significant complications of GCA. Prompt diagnosis and early initiation of corticosteroid therapy are crucial to prevent irreversible visual loss and further complications. A multidisciplinary approach involving ophthalmologists and other specialists is essential for the comprehensive management of GCA.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Giant Cell Arteritis With Bilateral Central Retinal Artery Occlusion and Tongue Necrosis

Brar,

Nanda,

Narayanan

et al. 2024

Cureus

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“…Other notable symptoms of temporal arteritis include jaw claudication, scalp tenderness, blurring of vision, fever, anorexia and polymyalgia [4]. Doppler ultrasound if available should be used as it has a good sensitivity and specificity (up to 80%) [5]. This is in addition to a raised erythrocyte sedimentation rate (ESR) above 100 mm/hour.…”

Section: Discussionmentioning

confidence: 99%

Giant cell arteritis-Where did we go wrong?

Kumar Devaraj

2019

Fortune J Rheumatol

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“…[2][3][4] GCA pathophysiology comprises wall vessels inflammation leading to arterial occlusion and tissue ischemia. 5 Main symptoms include muscle fatigue, headache, and visual alterations such as asdiplopia, amaurosis fugx, and loss of vision. Uncommon symptoms can be observed in some patients, such as tongue necrosis, which makes early diagnosis difficult.…”

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confidence: 99%

Lingual necrosis leading to the diagnosis of giant cell arteritis

Reis

Faustino

Vargas

et al. 2021

Special Care in Dentistry

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Giant cell arteritis (GCA) is a chronic vasculitis comprising large-and mediumsized arteries branches originating from the aortic arch. GCA diagnosis might be challenging due to its several clinical characteristics. This clinical report describes a case of a 91-year-old woman who was admitted with tongue necrosis.Medical history revealed mild headache episodes and jaw numbness. Summing up clinical and laboratory findings, the diagnosis of GCA was established. Surgical debridement and corticotherapy led to complete resolution of the tongue lesion with no need for any additional intervention. In this case report, we highlight the importance of GCA early diagnosis in order to avoid more serious complications. INTRODUCTIONGiant cell arteritis (GCA) is, also known as temporal arteritis, characterized as a vasculitis that affects arteries (medium and large), mainly the branches of the internal and external carotid arteries and the temporal artery. 1,2 GCA has an incidence of approximately 20 cases per 100,000 individuals and a prevalence of one case per 500 individuals. 3 The disease affects mostly females (1.4-3 women for every man) over 50 years with mean age around 70 years. [2][3][4] GCA pathophysiology comprises wall vessels inflammation leading to arterial occlusion and tissue ischemia. 5 Main symptoms include muscle fatigue, headache, and visual alterations such as asdiplopia, amaurosis fugx, and loss of vision. Uncommon symptoms can be observed in some patients, such as tongue necrosis, which makes early diagnosis difficult. 1 Ulcers or tongue necrosis, resulting from giant cell vasculitis, are extremely rare, mainly due to the excellent

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Giant Cell Arteritis Presenting with a Tongue Lesion

Cited by 4 publications

References 7 publications

Giant Cell Arteritis With Bilateral Central Retinal Artery Occlusion and Tongue Necrosis

Giant Cell Arteritis With Bilateral Central Retinal Artery Occlusion and Tongue Necrosis

Giant cell arteritis-Where did we go wrong?

Lingual necrosis leading to the diagnosis of giant cell arteritis

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