Abstract
Giant cell arteritis (GCA) is the most common systemic vasculitis affecting people over the age of 50 years, especially in the western world. Nevertheless, the initial diagnosis can be tricky, as some of the patients present at first time with a real unusual initial manifestation. One of these can be tongue necrosis, which is according to the literature in accordance with scalp necrosis, the rarest initial manifestation form of GCA. We describe two patients who presented with tongue necrosis as initial symptom of GCA. The diagnosis was made by the American College of Rheumatology criteria, biopsy and duplex sonography of their temporal arteries. A typical halo was seen as a sign of intimal edema. The patients were put on corticosteroids immediately after diagnosis was proven and their symptoms improved quickly.
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References
Gonzalez-Gay MA, Garcia-Porua C (2001) Epidemiology of the vasculitides. Rheum Dis Clin North Am. 27:729–749
Levine SM, Hellmann DB (2002) Giant cell arteritis. Curr Opin Rheumatol. 14:3–10
Salvarani C, Cantini F, Boiardi L, Hunder GG (2002) Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med. 347:261–271
Hunder GG, Bloch DA, Michel BA et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 33:1122–1128
Alberts MS, Mosen DM (2007) Diagnosing temporal arteritis: duplex vs. biopsy. QJM 100:785–789
Currey J (1997) Scalp necrosis in giant cell arteritis and review of the literature. BJR. 36:814–816
Biebl MO, Hugl B, Posch L, Tzankov A, Weber F et al (2004) Subtotal tongue necrosis in delayed diagnosed giant-cell arteritis: a case report. Am J Otolaryngol. 25:438–441
Goicochea M, Correale J, Bonamico L, Dominquez R, Bagg E et al (2007) Tongue necrosis in temporal arteritis. Headache. 47:1213–1215
Kleinjung T, Strutz J (1998) Spontane einseitige Zungennekrose. HNO. 46:274–275
Calamia KT, Hunder GG (1981) Giant cell arteritis (temporal arteritis) presenting as fever of undetermined origin. Arthritis Rheum 24:1414–1418
Carroll SC, Gaskin BJ, Danesh-Meyer HV (2006) Giant cell arteritis. Clin Experiment Ophthalmol. 34:159–173
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Brodmann, M., Dorr, A., Hafner, F. et al. Tongue necrosis as first symptom of giant cell arteritis (GCA). Clin Rheumatol 28 (Suppl 1), 47–49 (2009). https://doi.org/10.1007/s10067-009-1141-z
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DOI: https://doi.org/10.1007/s10067-009-1141-z