舌の疼痛を契機に診断に至った巨細胞性動脈炎の1例

Abstract

Giant cell arteritis (GCA) is a granulomatous arteritis containing giant cells that occur in the major branches of the aorta. Headache is frequently the first symptom, but oral symptoms may precede it. We report a case where giant cell arteritis presented as pain and swelling of the tongue with necrosis over time.The patient was a 78-year-old woman. She became aware of tongue pain and swelling from June 2019 and visited a nearby dental clinic. Her symptoms remained unimproved and was referred to our department in the same month for detailed examination and treatment. At her first visit, a painful, poorly-marginated dark purple mass was found extending from the left lateral edge of tongue to the proglossis. A vascular anomaly of the tongue was suspected, and contrast-enhanced MRI was performed but did not lead to a diagnosis. One week later, necrotic lesions were observed on her tongue and a blood test showed elevated inflammatory markers. A systemic disease was suspected, and medical examination at our hospital led to the diagnosis of GCA. Steroid