Table 1 Case reports and case series of GCA with tongue involvement
Authors | Date of publication | Age of patient | Clinical manifestations | Laboratory | Biopsy proven GCA | Treatment received | Extra-cranial large vessel vasculitis | Outcomes |
|---|---|---|---|---|---|---|---|---|
Zaragoza et al. [7] | 1/31/2015 | 68-year-old female | Moderate headache, swelling of the neck, and tongue edema with discoloration | ESR: 55Â mm/hr CRP: 130Â mg/L | Yes, bilateral temporal biopsies | 1Â mg/Kg corticosteroid | No | Extensive necrosis of the tongue that progressed to self-amputation |
Sobrinho et al. [8] | 3/23/2017 | 85-year-old male | Frontotemporal headache, jaw pain, tongue swelling, pain, and ulcers | ESR: 120Â mm/hr CRP: 172Â mg/L | Yes, temporal artery biopsy | 1Â mg/Kg corticosteroid and continue with methotrexate 10Â mg weekly | No | Improvement of the tongue necrosis without further progression in the lesion |
DeBord et al. [2] | 5/24/2019 | 77-year-old female | Tongue pain with ulcers, odynophagia, and dehydration | ESR: 65Â mm/hr | Yes, temporal artery biopsy | High dose of steroid | No | Tongue necrosis resolved |
Jennings et al. [9] | 12/2011 | 79-year-old female | Sore throat, bilateral occipital neck pain, dental pain, jaw claudication, and tongue necrosis | ESR: 75Â mm/hr | Yes, temporal artery biopsy | High dose of steroid | No | Tongue completely auto-amputating |
Oliver et al. [10] | 5/23/2022 | 86-year-old female | Headache, right amaurosis, jaw claudication, lingual burning sensation with subsequent ulceration | ESR: 82Â mm/hr | No | 40Â mg/day prednisone for 30Â days | No | Tongue necrosis improvement |
Bobinskas et al. [11] | 5/18/2015 | 65-year-old female | Paresthesia, pallor, cyanosis of the tongue | ESR: 42Â mm/hr | Yes, temporal biopsy | High dose of steroid | No | Tongue lesions improved |
Burg et al. [6] | 3/20/2021 | 78-year-old female | Visual change, bilateral temporal headache, thrusting bilateral pain in the mandible, tongue lesions, polymyalgia symptoms | ESR: 75Â mm/hr CRP: 71Â mg/l | No biopsy proven but ultrasound showed halo-sign for diagnostic purpose | Methylprednisolone 500Â mg daily for 5Â days then prednisone 60Â mg daily and 162Â mg tocilizumab weekly | No | Tongue lesion improved |
Lobato-Berezo et al. [12] | 9/26/2014 | 74-year-old female | Headache, blurred vision in her left eye, jaw pain, tongue pain and necrosis | No reported | Yes, right temporal artery biopsy | 1Â mg/Kg oral prednisone | No | Tongue lesion improved |
Fongaufier et al. [13] | 2018 | 66-year-old male | Bilateral headaches, tongue tenderness, jaw claudication, intermittent binocular diplopia with transient amaurosis | CRP: 120Â mg/L | Yes, temporal artery biopsy | 1.5Â mg/Kg for 3Â days | No | Emergent surgery for tongue resection with subsequent improvement |
Tseytlin et al. [14] | 1/2019 | 87-year-old female | Polymyalgia rheumatica symptoms, left jaw pain, dysphagia, tongue pain and ulceration | ESR: 68Â mm/hr | Yes, temporal artery biopsy | 50Â mg of prednisone and methotrexate | No | Tongue lesion improved |
Jalaledin et al. [15] | 10/14/2022 | 76-year-old female | Bilateral headache, fatigue, weight loss, jaw pain, sudden right eye vision loss, and tongue ulcer | CRP: 159Â mg/L | Yes, temporal artery biopsy | methylprednisolone IV 1Â g for 3Â days | No | Tongue lesion improved |
Donaldson et al. [16] | 6/1/2015 | 61-year-old female | Weight loss, myalgias, headache, jaw pain, and tongue lesions | CRP: 288Â mg/L | No, proven biopsy. CT chest showed thickening of the wall of the arch of the aorta | Steroid (dose not specified) | No | Tongue lesion improved |
Benedetti et al. [17] | 4/14/2020 | 77-year-old male | Mental status change, dysarthria, right tongue discoloration | ESR: 80Â mm/hr CRP: 390Â mg/L | Yes, right occipital artery | 1Â g IV methylprednisolone | No | Tongue lesion improved |
Biebl et al. [18] | 2004 | 79-year-old female | Left eye visual change, headache, abdominal pain, and togue necrosis | Â | Yes, right temporal artery biopsy | Prednisolone 100Â mg daily and azathioprine 100 daily | Â | Tongue necrosis stop spreading |
Grant et al. [19] | 2013 | 79-year-old female | Sudden vision loss of the left eye, occipital headache, ear, and jaw claudication, large necrotic tongue lesion | ESR: 68Â mm/hr CRP: 150Â mg/L | No | 500Â mg of IV methylprednisolone for 3Â days and continue high dose of steroid | No | Tongue lesions healed well |
Rose et al. [20] | 11/16/2021 | 81-year-old female | Occipital headache, right eye vision loss, stroke, tongue necrosis | ESR: 102Â mm/hr CRP: 163Â mg/L | Yes, temporal artery biopsy | 1Â g of IV methylprednisolone for 3Â days and continue with 60Â mg of oral prednisone | No | Tongue ulcer started after the pulse of steroid with subsequent improvement after continuing high dose of steroid |
Dos Reis et al. [21] | 1/10/2021 | 91-year-old female | Tongue ulcer, jaw numbness, hearing loss, visual impairment, swallowing difficulty, and mild headache episode | ESR: 22Â mm/hr CRP: 84Â mg/L | No | 1Â mg/Kg prednisone for 4Â weeks | No | Tongue necrosis improved |
Kumarasinghe et al. [22] | 11/19/2012 | 74-year-old female | Tongue lesion with numbness, and pain, mild headaches, jaw pain on chewing | ESR: 103Â mm/hr CRP: 37Â mg/l | Yes, temporal artery biopsy | 40Â mg of prednisolone daily, initial loading dose 300Â mg with subsequent 75Â mg daily | Â | Tongue necrosis improved |
Husein-ElAhmed et al. [23] | 1/8/2010 | 76-year-old female | Painful tongue necrosis and swelling | ESR: 87Â mm/hr | Yes, temporal artery biopsy | High dose of corticosteroida | No | Tongue necrosis improved |
Brodmann et al. [24] | 3/10/2009 | a. 81-year-old male b. 79-year-old female | a. Tongue ulcer b. Right sudden visual loss, headache, right temporal headache, jaw claudication | a. ESR: 52Â mm/hr b. ESR 70Â mm/hr | a. Yes, temporal artery biopsy b. Yes, temporal artery biopsy | a. High dose of steroida b. High dose of steroida | a. No b. Yes, FDG-PET uptake in both subclavian arteries | a. Tongue necrosis improved b. Tongue necrosis improved |