title: Subtotal tongue necrosis in delayed diagnosed giant-cell arteritis: a case report.
abstract: Giant-cell arteritis (GCA) is a chronic systemic vasculitis of large- and medium-sized vessels, mainly affecting elderly patients. Headache, vision impairment, jaw claudication, and scalp tenderness are common symptoms. However, diagnosis can be difficult because GCA can affect almost every vascular pathway and lead to a variety of possible manifestations. We report the case of a belated diagnosed GCA, resulting in nearly complete necrosis of the mobile part of the tongue, visual impairment, and neurologic as well as intestinal ischemic symptoms. Aggressive immunosuppressive treatment resolved the symptoms, but the patient remained severely morbid because of bilateral necrosis of the mobile part of the tongue. In any case of unclear ischemic symptoms in an elderly patient, one must keep GCA in mind as the possible culprit disease.
authors.affiliation: Department of Vascular Surgery, University Hospital, Innsbruck, Austria.
authors.forename: Matthias Oliver
authors.initials: MO
authors.lastname: Biebl
authors.forename: Beate
authors.initials: B
authors.lastname: Hugl
authors.forename: Lydia
authors.initials: L
authors.lastname: Posch
authors.forename: Alexandar
authors.initials: A
authors.lastname: Tzankov
authors.forename: Florian
authors.initials: F
authors.lastname: Weber
authors.forename: Reinhold
authors.initials: R
authors.lastname: Perkmann
authors.forename: Gustav
authors.initials: G
authors.lastname: Fraedrich
mesh_terms: D000368:Aged; D001379:Azathioprine / Q000627:therapeutic use; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009336:Necrosis; D011239:Prednisolone / Q000627:therapeutic use; D014059:Tongue / Q000473:pathology*; D014786:Vision Disorders / Q000209:etiology
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine