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NEJM:巨细胞动脉炎所致舌坏死

2018-07-06 杨中华 脑血管病及重症文献导读

疲劳,头痛和吞咽困难15天。 既往,每天服用阿司匹林。 查体发现可以触及双侧颞动脉明显搏动。无发热或头皮压痛,眼科检查正常。 实验室检查显示白细胞14950/mm3,血沉为120 mm/h。 诊断为巨细胞动脉炎。双侧颞动脉活检,并开始激素治疗。

疲劳,头痛和吞咽困难15天。

既往,每天服用阿司匹林。

查体发现可以触及双侧颞动脉明显搏动。无发热或头皮压痛,眼科检查正常。

实验室检查显示白细胞14950/mm3,血沉为120 mm/h。

诊断为巨细胞动脉炎。双侧颞动脉活检,并开始激素治疗。

活检结果确认诊断为巨细胞动脉炎。

入院8天后患者因为舌头疼痛再次到急诊室就诊。发现右侧舌部坏死性溃疡。

颈颜面部增强CT显示右侧舌动脉血栓形成。



舌部坏死是一种巨细胞动脉炎的罕见并发症。在激素治疗基础上,患者的症状2周内逐渐缓解,4周时舌损害完全恢复。

文献出处:

Laurent Truffaut,et al.Tongue Necrosis in Giant-Cell Arteritis.N Engl J Med. 2018 Jun 28;378(26):2517. doi: 10.1056/NEJMicm1709412.

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    2018-07-16 xsm927
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    2018-07-08 millore
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    2018-07-08 wwzzly
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    2018-07-07 龙胆草

    学习谢谢分享

    0

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    2018-07-06 清风拂面

    谢谢分享学习

    0

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