Raynaud phenomenon causing lingual pallor and dysarthria

Chatterjee, Soumya

doi:10.1503/cmaj.150547

Cited by 6 publications

(8 citation statements)

References 6 publications

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“…Raynaud's phenomenon of the tongue is exceedingly uncommon and often occurs in the setting of primary Raynaud's disease of the digits. There have been at least 22 cases of lingual involvement reported in the literature, usually associated with systemic sclerosis, Sjögren's syndrome, or other connective tissue disorders [3][4][5][6][7][8]. Of the lingual Raynaud's cases found in the literature, four were identified without preexisting connective tissue disease all occurring after the use of radiotherapy for head and neck squamous cell carcinomas [2,[9][10][11].…”

Section: Discussionmentioning

confidence: 99%

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Lingual Raynaud’s Phenomenon after Surgical and Radiotherapeutic Intervention for Oral Squamous Cell Carcinoma

Murphy

Kabbani

Shepard

et al. 2022

Case Reports in Vascular Medicine

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Raynaud’s phenomenon of the tongue after radiation therapy with or without chemotherapy is an exceedingly rare complication. Symptoms are similar to Raynaud’s disease of other sites and involve pallor and discomfort on exposure to cold temperatures that resolve with rewarming. Presentation occurs approximately 18-24 months after radiotherapy on average and can usually be managed effectively with lifestyle modification and pharmacotherapy. Here, we present a case of lingual Raynaud’s following surgery and adjuvant radiation therapy in a patient with squamous cell carcinoma of the oral cavity.

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Section: Discussionmentioning

confidence: 99%

“…Case Reports in Vascular Medicine with a previously diagnosed systemic sclerosis with digital Raynaud's symptoms [3][4][5][6][7][8].…”

Section: Discussionmentioning

confidence: 99%

Lingual Raynaud’s Phenomenon after Surgical and Radiotherapeutic Intervention for Oral Squamous Cell Carcinoma

Murphy

Kabbani

Shepard

et al. 2022

Case Reports in Vascular Medicine

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“…Raynaud’s phenomenon of the tongue is rare, in part due to its excellent circulation 9. It has been most frequently described in patients with underlying autoimmune disease including systemic sclerosis,10 11 Sjogren’s syndrome12 and mixed CTD 13. Therefore, a thorough clinical assessment and targeted investigations are required to rule out secondary causes in all patients presenting with lingual Raynaud’s phenomenon.…”

Section: Discussionmentioning

confidence: 99%

“…Persisting symptoms or ulceration should prompt investigation for an alternative cause, such as vasculitis, lingual artery thrombosis or acrocyanosis. Like other forms of Raynaud’s phenomenon, the described triggers for lingual Raynauds phenomenon include cold, temperature changes and emotional stress 10 14. In some cases, no obvious triggers can be found 16.…”

Section: Discussionmentioning

confidence: 99%

Lingual Raynaud’s phenomenon: a rare presentation

Biddle

Kaul

2022

BMJ Case Rep

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A woman in her mid-60s presented to transient ischaemic attack (TIA) clinic with a 3-year history of intermittent sensory changes and white discolouration affecting the left side of her tongue. Following extensive investigation, a provisional diagnosis of posterior circulation TIA was made, and the patient was commenced on clopidogrel therapy. Despite anti-platelet treatment, she continued to have identical episodic symptoms. She was referred to the rheumatology team for assessment of possible underlying autoimmune pathology. On rheumatology assessment, the patient reported colour changes on the tongue, associated with numbness, followed by paraesthesia of the affected area. A comprehensive assessment excluded secondary causes and a diagnosis of primary Raynaud’s phenomenon of the tongue was made. The diagnosis of TIA was revoked. This case illustrates a rare presentation of a common condition and highlights the sensory symptoms which are associated with Raynaud’s phenomenon.

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“…Lingual Raynaud’s is rare due to the excellent collateral circulation in the tongue but has been previously reported in association with radiotherapy [1] and scleroderma [2] , but interestingly is not associated with poorer outcomes in autoimmune conditions [2] . Transient dysarthria and paraesthesia are also recognised associated symptoms [3] . Persisting symptoms or ulceration should alert the clinician to an alternative vascular cause such as vasculitis, atherosclerosis or labile blood pressure.…”

Section: Discussionmentioning

confidence: 99%

Raynaud's of the Tongue

Perry

Surtee

Nawaz

2017

European Journal of Case Reports in Internal Medicine

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We describe a 40-year-old lady who presents with a painful white tongue on exposure to the cold. The differential diagnosis and investigations are outlined with a discussion about this unusual presentation of a common problem.LEARNING POINTS • Raynaud's can affect areas of the body besides the digits.• Lingual Raynaud's should be considered in patients with transient tongue pain.• Alternative diagnoses should be sought if ulceration or permanent symptoms develop. KEYWORDS Raynaud's, tongue CASE DESCRIPTION A 40-year-old woman presented with intermittent, 20 minute episodes of sequential painful white and blue tongue discoloration upon exposure to the cold. The peripheral rim of her tongue was relatively spared and on re-warming, the tongue became bright red associated with a burning sensation. The episodes caused moderately severe discomfort with dysarthria and stiffness at the back of the tongue as well as hypersalivation. The patient had a past history of vitamin B12 deficiency and was a smoker. There was no concurrent digital vasospasm of fingers or toes, lips or nipples. She did not have a past medical history of any connective tissue disease. Physical examination was normal but the tongue colour change is shown in Figure 1. Laboratory testing was negative for anti-nuclear antibody and rheumatoid factor. Other blood investigations demonstrated no abnormalities in biochemistry, haematology, ESR or clotting profile.

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Raynaud phenomenon causing lingual pallor and dysarthria

Cited by 6 publications

References 6 publications

Lingual Raynaud’s Phenomenon after Surgical and Radiotherapeutic Intervention for Oral Squamous Cell Carcinoma

Lingual Raynaud’s Phenomenon after Surgical and Radiotherapeutic Intervention for Oral Squamous Cell Carcinoma

Lingual Raynaud’s phenomenon: a rare presentation

Raynaud's of the Tongue

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