NEJM传真巨细胞动脉炎伴发舌坏死

An86-year-oldwomanpresentedtotheprimarycareclinicwitha5-dayhistoryoffatigue,headache,anddifficultyswallowing.Herbaselinemedicationregimenincludeddailyaspirin.Physicalexaminationwasnotableforpalpableandpulsatiletemporalarteriesonbothsides.Therewasnofeverorscalptenderness,andtheresultsofophthalmologicexaminationwerenormal.Laboratorystudiesrevealedawhite-cellcountof4,percubicmillimeter(referencerange,to,)andanerythrocytesedimentationrateof20mmperhour(referencerange,to2).Adiagnosisofgiant-cellarteritiswasconsideredtobelikely.Biopsiesofbothtemporalarterieswereperformed,andtreatmentwithglucocorticoidswasinitiatedbeforetheresultsofpathologicalanalysiswereavailable.Thebiopsyresultsconfirmedthediagnosisofgiant-cellarteritis.Eightdaysafterherinitialpresentation,thepatientpresentedtotheemergencydepartmentwithtonguepain.Anecroticulcerationwasobservedontherightsideofthetongue.Cervicofacial







































治白癜风医院
白癜风有哪些危害

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