Temporal arteritis and gangrene of the tongue

A 69-year-old woman, suspected of having polymyalgia rheumatica, was biopsied from the temporal artery to establish the diagnosis. Six hours after the biopsy, she developed progressive gangrene of the tongue and the floor of the mouth, and intensive steroid therapy was initiated. The histological examination of the biopsy revealed giant-cell arteritis. Biopsy or other manipulation of the artery is suggested to be the cause of exacerbation of the arteritis locally. Steroid treatment is proposed in all cases prior to the biopsy. Other studies have not shown that the possibility of obtaining a positive histological diagnosis is reduced during or after steroid treatment. A review of the literature on gangrene of the tongue is given.