Table 1: Literature review of temporal arteritis and tongue necrosis in adults.
| Ref. | Age/Sex | Pmr | Trigger | Esr | Presenting symptoms | Modality for diagnosis | Treatment |
| Current Case | 68/F | No | Icatibant | 55 | Tongue pain and swelling; neck swelling; HA | CT angiogram with beading; bilateral TA biopsy + |
High-dose steroids |
| 2 | 78/F | No | None | 69 | Sore tongue, pain while eating, blurred vision | Color-coded duplex of temporal arteries: occlusion of left artery | High-dose steroids |
| 4 | 88/F | No | None | 78 | Painful tongue and generalized weakness | TA biopsy + | High-dose steroids |
| 5 | 79/F | No | Ergotamine tartrate | 113 | Painful tongue, dysphagia, blurred vision | TA biopsy + Tongue biopsy: necrosis |
High-dose steroids |
| 6 | 66/F | No | None | 77 | HA, tongue swelling on the left | TA biopsy + | Pulse steroids over 3 days |
| 7 | 69/F | Yes | None | 134 | Fever, pain in neck and jaw, paresthesias of the tongue | Right TA biopsy + | High-dose steroids |
| 8 | 79/F | No | None | 78 | Syncope, abdominal pain, impaired vision of left eye, tongue pain | - Ultrasound of right TA: - TA biopsy + |
High-dose steroids and azathioprine |
| 9 | 75/F | Yes | Ergotamine tartrate | 90 | Difficulty with moving tongue | - Carotid angiography: multiple narrowings, bilateral occluded external carotid arteries | High-dose steroids, heparin and azathioprine |
| 10 | 82/F | No | None | 34 | Swollen tongue, erythematous lesions on right | - Biopsy of right TA + side of scalp |
High-dose steroids |
| 11 | 81/M | No | None | 52 | Right-sided tongue ulcer of unknown origin | - Ultrasound of temporal arteries: halo of right TA - PET + in TA - Right TA biopsy + |
High-dose steroids |
| 11 | 79/F | No | None | 70 | Sudden visual loss of right eye, HA, jaw claudication | - Color-coded duplex: left-sided intimal edema - PET: uptake in subclavian arteries - TA biopsy + |
High-dose steroids |
| 12 | 77/F | No | None | 40 | Severe HA, chin cyanosis, right tongue and lip infarction | - Brain MRI and CSF: normal - Carotid and transcranial doppler: normal - Tongue biopsy: necrosis - Angiography: bilateral carotid arteritis - TA biopsy + |
High-dose steroids, cyclophosphamide |
| 12 | 73/F | No | None | 42 | Fronto-temporal HA, arthralgias, loss of vision in right eye, tongue edema, dysarthria | - Orbital and brain MRI: normal - Intra-and extracranial angio-MRI: stenosis of right internal carotid artery - Cerebral angiography: subocclusion of the right carotid siphon |
High dose steroids |
| 12 | 78/F | No | None | 125 | HA, left eye vision loss, tongue pain | - Left TA duplex: findings consistent vasculitis - TA biopsy +\ |
High dose steroids |
| 13 | 75/F | No | None | 80 | Severe HA, blanching tongue and burning sensation of the tongue | - Right TA biopsy + | High dose steroids |
| 14 | 79/F | No | None | 115 | Dry cough, toothache and tongue pain, right vision loss | - TA biopsy + | High dose steroids |
| 15 | 73/F | No | None | 110 | Severe throbbing HA, necrosis of the tip of the tongue | NR | High dose steroids |
| 15 | 80/F | No | None | 99 | Pain in thigh, HA, pain and ulceration of the tongue | NR | High dose steroids |
| 16 | 86/F | No | None | 25 | Dysarthria and painful tongue | - TA biopsy + | High dose steroids |
| 17 | 83/M | No | None | 110 | Progressive HA, right-sided tongue pain | - TA biopsy + | High dose steroids |
| 18 | 82/F | No | None | raised | Acute abdominal pain, fever, painful tongue | - Biopsy of tongue: necrotic tissue - TA biopsy negative - Biopsy of viable tongue + |
High dose steroids |
| 19 | 77/F | No | None | 100 | Left-sided tongue and jaw pain | Left TA biopsy + | High dose steroids |
| 20 | 58/M | No | None | 67 | Difficulty swallowing, tongue swelling, blurred vision | TA biopsy + | High dose steroids |
| 21 | 68/F | No | Ergotamine tartrate | 32 | Bitemporal HA bilateral mandibular pain, swelling and cyanosis of the tongue | TA biopsy + | High dose steroids |
| 21 | 68/F | No | None | 55 | Bilateral jaw pain, left-sided tongue swelling and burning sensation | TA biopsy + | High dose steroids |
| 21 | 74/M | No | None | 73 | Slurred speech, diminished tongue and lip sensation, HA | Tongue biopsy: no neoplasm TA biopsy + |
High dose steroids |
| 22 | 68/F | No | Ergotamine | 32 | Throbbing HA, tongue numbness and difficulty swallowing | TA biopsy + | High dose steroids |
| 23 | 77/F | No | None | 68 | Pain in jaw/ tongue, ischemic left tongue | TA biopsy + | High dose steroids |
| 24 | 72/F | No | Ergotamine tartrate | NR | Pain at base of tongue; necrosis of anterior half of tongue bilaterally | Arteriogram showed stenosis and irregularities in both external carotid arteries- Right TA biopsy + | High dose steroids 40 mg TID |
| 25 | 72/F | No | None | 54 | Bitemporal pain, whole tongue swelling | No Biopsy | Anticoagulation |
| 26 | 79/F | Yes | None | 78 | Loss vision left eye, myalgias, tongue swollen | TA biopsy right temporal + | High dose steroids and azathioprine and aspirin |
| 27 | 79/F | No | None | 75 | HA, Jaw claudication, neck pain, visual deterioration, painful tongue | TA biopsy + | High-dose steroids |
| 28 | 74/F | No | None | raised | HA, with left-sided ptosis, blurred vision, fatigue, jaw pain and anorexia | TA biopsy + | High-dose steroids |
| 29 | 74/M | No | None | 132 | HA, tongue necrosis, jaw pain, scalp pain | TA biopsy + | High-dose steroids |
PMR: Polymyalgia Rheumatic, TA: Temporal Artery, HA: Headache, F: Female, M: Male, ESR: Erythrocyte Sedimentation Rate, REF: References, NR: Not Reported, + Histology Positive for GCA, Mean age = 75; gender ratio 4:1 female; 15% with trigger; 10% had PMR symptoms; ESR > 50.