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Annals of the Rheumatic Diseases Feb 2024
Topics: Humans; Polymyalgia Rheumatica; Giant Cell Arteritis; Syndrome
PubMed: 38071513
DOI: 10.1136/ard-2023-225192 -
Annals of the Rheumatic Diseases Oct 2022
Topics: Giant Cell Arteritis; Humans; Immune Checkpoint Inhibitors; Polymyalgia Rheumatica; Synovitis
PubMed: 32241799
DOI: 10.1136/annrheumdis-2020-217381 -
Postgraduate Medicine Oct 1989Polymyalgia rheumatica is a clinical syndrome that occurs almost exclusively in older patients. It is characterized by muscle aching and stiffness and an elevated... (Review)
Review
Polymyalgia rheumatica is a clinical syndrome that occurs almost exclusively in older patients. It is characterized by muscle aching and stiffness and an elevated erythrocyte sedimentation rate. It must be distinguished from other common disorders, particularly polymyositis, fibromyalgia, and other chronic inflammatory or neoplastic diseases. A temporal artery biopsy should be done in patients with confirmed polymyalgia rheumatica and suspected coexistent temporal arteritis, which can have serious manifestations. Patients with polymyalgia rheumatica respond dramatically to low doses of corticosteroids, although prolonged daily treatment often may be needed.
Topics: Aged; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Polymyalgia Rheumatica
PubMed: 2678057
DOI: 10.1080/00325481.1989.11704437 -
Clinical and Experimental Rheumatology 2000Polymyalgia rheumatica is a relatively common syndrome of the elderly characterized by severe pain and stiffness in the neck shoulder and pelvic girdles, along with... (Review)
Review
Polymyalgia rheumatica is a relatively common syndrome of the elderly characterized by severe pain and stiffness in the neck shoulder and pelvic girdles, along with increased acute phase reactants. The current diagnostic criteria include as a requirement an erythrocyte sedimentation rate (ESR) higher than 30 or 40 mm/1 hr. Nevertheless, in several reports, a sizable proportion of patients with PMR, from 7% up to 22%, had an ESR that was either normal or slightly increased at the time of diagnosis, supporting the notion that an increased ESR should not be an absolute requirement for its diagnosis. This subset is characterized by a younger age, a less marked predominance of females, a longer diagnostic delay and a lower frequency of constitutional symptoms such as fever or weight loss. When determined, a majority of these patients had increased levels of C reactive protein. The recognition of this subset of patients with PMR and a low ESR can be very useful to the clinician, avoiding unnecessary suffering of the patients and the risks of ineffective therapy with nonsteroidal antiinflammatory drugs. To avoid the over-diagnosis of PMR in patients with a low ESR, we propose a set of criteria that can be easily applied in daily practice to patients with a clinical picture consistent with PMR but with a normal or slightly increased ESR.
Topics: Blood Sedimentation; C-Reactive Protein; Humans; Polymyalgia Rheumatica
PubMed: 10948758
DOI: No ID Found -
Seminars in Arthritis and Rheumatism Oct 2022Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) can be concurrent diseases. We aimed to estimate the point-prevalence of concurrent GCA and PMR.... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) can be concurrent diseases. We aimed to estimate the point-prevalence of concurrent GCA and PMR. Additionally, an incidence rate (IR) of GCA presenting after PMR diagnosis in patients was estimated.
METHODS
Two authors performed a systematic literature search, data extraction and risk of bias assessment independently. Studies assessing cohorts of patients presenting with both GCA and PMR were included. The outcomes were point-prevalence of concurrent GCA and PMR and IR for development of GCA after PMR diagnosis. A meta-analysis was performed to calculate a pooled prevalence of concurrent PMR and GCA.
RESULTS
We identified 29 studies investigating concurrent GCA and PMR. Only two studies applied imaging systematically to diagnose GCA and none to diagnose PMR. GCA presenting after PMR diagnosis was assessed in 12 studies but imaging was not applied systematically. The point-prevalence of concurrent GCA present at PMR diagnosis ranged from 6%-66%. The pooled estimate of the point-prevalence from the meta-analysis was 22%. The point-prevalence of PMR present at GCA diagnosis ranged from 16%-65%. The pooled estimate of the point-prevalence from the meta-analysis was 42%. The IR ranged between 2-78 cases of GCA presenting after PMR per 1000 person-years.
CONCLUSION
This review and meta-analysis support that concurrent GCA and PMR is frequently present at the time of diagnosis. Additionally, we present the current evidence of GCA presenting in patients after PMR diagnosis. These results emphasize the need for studies applying imaging modalities to diagnose GCA.
Topics: Diagnostic Imaging; Giant Cell Arteritis; Humans; Incidence; Polymyalgia Rheumatica; Prevalence
PubMed: 35858507
DOI: 10.1016/j.semarthrit.2022.152069 -
Archives of Internal Medicine Jul 1985
Topics: Aged; Aging; Blood Sedimentation; Female; Humans; Ibuprofen; Middle Aged; Polymyalgia Rheumatica; Prednisone
PubMed: 4015278
DOI: No ID Found -
Expert Review of Clinical Immunology Oct 2016Polymyalgia rheumatica is one of the most common rheumatic inflammatory disorders in people older than 50 years characterized by aching and prolonged morning stiffness... (Review)
Review
INTRODUCTION
Polymyalgia rheumatica is one of the most common rheumatic inflammatory disorders in people older than 50 years characterized by aching and prolonged morning stiffness in the shoulder and pelvic girdle and neck..
AREAS COVERED
In this review, we will focus on recent advances on the diagnosis and management of PMR. Expert commentary: Controversy exist whether PMR represent a single entity disease or is an umbrella term that comprises a clinical presentation common to a range of related conditions (polymyalgic syndrome). To date there are no specific diagnostic tests, and the diagnosis remains clinical, although ultrasonography, positron emission tomography scan and the recent ACR/EULAR classification criteria may help to confirm the clinical diagnosis. A step-wise process for the diagnosis of PMR has been proposed. Low-dose steroids are highly effective in the majority of patients and remain the mainstay of treatment, but relapses occur in about 50% of patients and glucocorticoid related adverse event are common. The steroid sparing effects of the immunosuppressive treatment evaluated to date are unclear.
Topics: Algorithms; Animals; Antibodies, Monoclonal, Humanized; Biomarkers; Diagnosis, Differential; Humans; Immunotherapy; Interleukin-6; Polymyalgia Rheumatica; Positron-Emission Tomography; Steroids; Ultrasonography
PubMed: 27079756
DOI: 10.1080/1744666X.2016.1178572 -
Zeitschrift Fur Rheumatologie Mar 2024
Topics: Humans; Polymyalgia Rheumatica; Giant Cell Arteritis; Antibodies, Monoclonal, Humanized
PubMed: 38240818
DOI: 10.1007/s00393-024-01474-2 -
Clinical and Experimental Rheumatology 2000
Review
Topics: Aging; Animals; Endocrine Glands; Humans; Hypothalamo-Hypophyseal System; Immune System; Pituitary-Adrenal System; Polymyalgia Rheumatica
PubMed: 11138324
DOI: No ID Found -
Reumatismo Mar 2018Polymyalgia rheumatica (PMR) is one of the most common rheumatic inflammatory disorders in people aged over 50. It is characterized by aching and prolonged morning... (Review)
Review
Polymyalgia rheumatica (PMR) is one of the most common rheumatic inflammatory disorders in people aged over 50. It is characterized by aching and prolonged morning stiffness in the shoulder and pelvic girdles and neck. To date there are no specific diagnostic tests, and in clinical practice the diagnosis of PMR remains based on its characteristic clinical manifestations, laboratory evidence of systemic inflammation, rapid response to low doses of glucocorticoids and exclusion of other disorders that may present with proximal pain and stiffness. For classification purposes, several criteria have been proposed over time based on retrospective clinical series, but none have been validated and received universal acceptance. Recently, an international collaborative initiative between the EULAR and the ACR was undertaken to develop new polymyalgia rheumatica classification criteria. In this review, the provisional 2012 EULAR/ACR classification criteria will be presented and their contribution for the diagnosis of polymyalgia rheumatica will be discussed.
Topics: Aged; Biomarkers; Diagnosis, Differential; Glucocorticoids; Humans; Inflammation; Pain; Polymyalgia Rheumatica; Range of Motion, Articular; Treatment Outcome
PubMed: 29589399
DOI: 10.4081/reumatismo.2018.1107