RESEARCH - Clinical features in patients with polymyalgia rheumatica

March 28, 2011

Nihon Rinsho Meneki Gakkai Kaishi. 2009 Aug;32(4):274-8.

[Clinical features in patients with polymyalgia rheumatica].

[Article in Japanese]

Aoki Y, Iwamoto M, Minota S.

Division of Rheumatology and Clinical Immunology, Department of

Medicine, Jichi Medical University, Tochigi, Japan.

Abstract

Polymyalgia rheumatica (PMR) is an inflammatory disease of unknown

etiology affecting elderly patients and characterized by muscle pain

and morning stiffness in proximal areas (pelvic and shoulder girdles

and neck). It is sometimes difficult to distinguish PMR from

rheumatoid arthritis (RA), or vasculitis. In the present study, we

examined the clinical characteristics of the patients diagnosed with

PMR in our hospital retrospectively. There were 44 patients with the

median age of 71s. Eighty percent of the patients were in their 60s or

70s, and 3 patients (6.8%) were in there 50s or younger. There was no

sex preponderance in frequency. Fifteen patients (34%) presented with

both proximal and distal muscle pain. Arthritis occurred in 16

patients (36%), the half of which was monarthritis or oligoarthritis,

and was more involved in wrist or knee joint. Only 3 patients had

temporal arteritis (TA) complicated with PMR. Mean of maximum serum

CRP was 8.18 mg/dl, and rheumatoid factor and anti-CCP antibodies were

positive in 2 patients and a patient, respectively. There was no

patient positive for ANCA. Serum MMP-3 levels tended to be higher in

female patients. Median of maximum prednisolone (PSL) dose used for

the treatment was 0.195 mg/kg of body weight daily. No patient needed

any immunosuppressants. In the 26 patients we had a chance to follow,

there were no patients who developed RA 6 months after the initial

diagnosis. Progression from PMR to RA was reported, and mean period

between the diagnosis of PMR and RA was one to 5 years.

PMID: 19721349

Not an MD

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