Tongue Necrosis as an Initial Manifestation of Giant Cell Arteritis: Case Report and Review of the Literature

Table 3

Literature review of bilateral necrosis of the tongue in giant cell arteritis.

Reference	Patient age	Previous symptoms	Presentation	Studies	ACR criteria	Treatment
Oliver et al. [2]	79	An episode of collapse, decreased vision on left eye, and abdominal pain with segmental small bowel necrosis	New-onset, spontaneous bilateral necrosis of the tongue	Erythrocyte sedimentation rate (ESR): 78; Ultrasound of temporal artery: thickened artery with halo	Yes	Prednisolone and azathioprine 100 mg/d each
Zadik et al. [5]	78	Pain of the right head, neck, and shoulder. Fatigue, visual blurring, and weight loss for last 2 mo	Sore tongue, bilateral swelling and pain	Erythrocyte sedimentation rate (ESR): 69; Ultrasound of left temporal artery revealed occlusion	Yes	Prednisone 60 mg/d
Schurr et al. [9]	66	Slurred speech, dysphagia for 2 weeks	Swelling of the tongue with a greyish-purple color	Erythrocyte sedimentation rate (ESR): 120; CT angio.: 3 cm long stenosis with 50% at left common carotid artery	No	Prednisone 500 mg/d 3 d, then 100 mg/d
Sainuddin and Saeed [10]	82		Acute abdominal pain, fever, and intestinal infarction	Autopsy confirmed giant cell arteritis affecting intestine and temporal artery	Yes
Patterson et al. [11]	88	Generalized weakness. Painful, swollen, and discolored tongue for 10 days	Ischemic tongue, tender to palpation, and decreased movement		Yes	Prednisone 40 mg daily