Pfeil Alexander, Hoffmann Tobias, Freesmeyer Martin, Oelzner Peter, Wolf Gunter
Universitätsklinikum Jena, Klinik für Innere Medizin III, Friedrich-Schiller-Universität Jena, Am Klinikum 1, 07747, Jena, Deutschland.
Universitätsklinikum Jena, Klinik für Nuklearmedizin, Friedrich-Schiller-Universität Jena, Jena, Deutschland.
Inn Med (Heidelb). 2024 May;65(5):508-511. doi: 10.1007/s00108-023-01607-w. Epub 2023 Oct 20.
An 83-year-old male patient presented due to a 3-week history of swelling of the tongue with tongue pain on eating, yellowish plaques, and a gray-brown lesion in the anterior portion of the tongue. Sudden loss of vision in the left eye and temporal headache occurred 3 days before presentation. Due to elevated C‑reactive protein, sonography of the supraaortic arteries as well as positron emission tomography/computed tomography was performed. Imaging revealed inflammation of the great arteries as well as a halo sign on ultrasound of the temporal artery. Thus, a diagnosis of giant cell arteritis with necrosis of the tongue was made. Immunosuppressive therapy with glucocorticoids was initiated. Necrosis of the tongue is a rare manifestation of giant cell arteritis that requires immediate immunosuppressive therapy to prevent further complications to the tongue (e.g., complete necrosis of the tongue, superinfection, tongue amputation).
一名83岁男性患者因舌头肿胀3周就诊,进食时伴有舌痛、黄色斑块,舌前部有灰棕色病变。就诊前3天出现左眼突然失明和颞部头痛。由于C反应蛋白升高,进行了主动脉弓上动脉超声检查以及正电子发射断层扫描/计算机断层扫描。影像学检查显示大动脉炎症以及颞动脉超声上的晕征。因此,诊断为巨细胞动脉炎伴舌坏死。开始使用糖皮质激素进行免疫抑制治疗。舌坏死是巨细胞动脉炎的一种罕见表现,需要立即进行免疫抑制治疗以防止舌头出现进一步并发症(如舌完全坏死、二重感染、舌截肢)。