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Temporal arteritis: a cough, toothache, and tongue infarction
1Johns Hopkins University School of Medicine, Department of Medicine, Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA. hellmann@jhmi.edu
JAMA
|June 8, 2002
Summary
Temporal arteritis, a common vasculitis, can present with unusual symptoms like dry cough and vision loss. Early recognition of these atypical signs is crucial for timely diagnosis and treatment to prevent irreversible vision loss.
Area of Science:
- Rheumatology
- Vascular Medicine
Background:
- Temporal arteritis (TA), a prevalent systemic vasculitis, primarily affects older adults.
- It is characterized by panarteritis, predominantly involving the extracranial carotid artery branches.
Observation:
- A case of a 79-year-old woman with atypical TA symptoms including dry cough, toothache, tongue infarction, and vision loss is presented.
- Typical TA onset is around 72 years, with common symptoms like headache, jaw claudication, and visual disturbances.
Findings:
- Elevated erythrocyte sedimentation rate (>50 mm/h) is noted in 89% of patients.
- Approximately 40% of TA cases exhibit atypical manifestations, such as fever of unknown origin, respiratory symptoms (dry cough), and large artery involvement.
Implications:
- Recognizing unusual presentations of temporal arteritis is vital for prompt diagnosis.
- Early intervention can mitigate severe complications, most notably preventing permanent vision loss.
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