Giant cell arteritis presenting with progressive dysphagia and tongue necrosis.

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Date: Mar. 21, 2022
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 11)
Publisher: CMA Impact Inc.
Document Type: Clinical report
Length: 588 words
Lexile Measure: 1170L

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A 72-year-old man was admitted to hospital with 1 month of progressive solid food dysphagia that caused a 10-kg weight loss. The patient reported alcohol and tobacco use but had no known medical conditions. An oral examination and head and neck computed tomography (CT) were normal apart from poor dentition. Laboratory investigations showed a raised C-reactive protein level (54.4 [normal < 5] mg/L) and normal leukocyte count (6.83 [normal 4.0-10.0] *[10.sup.9]/L). Gastroscopy and barium swallow test were unremarkable. He was discharged without a diagnosis.

The patient returned to hospital 1 week later with severe oral and maxillary pain and persistent dysphagia. We found a lingual lesion with white coating (Figure 1A). The result for a repeat C-reactive protein test was 117.6 mg/L and the patient's leukocyte count was 11.04 *[10.sup.9]/L.

Two days later, the left lingual lesion had become necrotic (Figure 1B). We suspected malignant disease and...

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Gale Document Number: GALE|A697327358