Polymyalgia Rheumatica

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Authors: Bhaskar D
Polymyalgia rheumatica (PMR) is among the most common reasons for long-term steroid prescription with great heterogeneity in presentation, response to steroids and disease course. The British Society for Rheumatology and the British Health Professionals in Rheumatology have recently published guidelines on management of PMR. The purpose of this concise guidance is to draw attention to the full guidelines and provide a safe and specific diagnostic process with advice on management and monitoring–specifically targeted at general practitioners, general physicians and rheumatologists.
PMID: 20726461 [PubMed - in process] (Source: Clinical Medicine)
MedWorm: Polymyalgia Rheumatica

Abstract  A case of apoplectic lymphocytic hypophysitis complicated by polymyalgia rheumatica (PMA) is described. A 72-year-old man
was admitted to our hospital due to severe headache. Two months prior to admission, the patients had exhibited recent-onset
stiffness and myalgia of shoulder and pelvic girdle that was compatible with PMR. Magnetic resonance imaging revealed a mass
lesion in the pituitary fossa with focal hemorrhage. Endocrinologic studies demonstrated hypopituitarism. The headache and
myalgia were improving with corticosteroid treatment; however, a trans-sphenoidal surgery was performed due to visual field
loss. A white-colored mass was resected, and histologic examination showed diffuse infiltration of lymphocytes and plasma
cells consistent with lymphocytic …
MedWorm: Polymyalgia Rheumatica

Authors: Geijteman E, Kramer M, Nanayakkara P
Although anecdotal reports pointing to the occurrence of episodes of shortness of breath due to prednisone use have been published, systematic evidence is lacking. In this manuscript we report on an n=1 trial in a patient using prednisone for polymyalgia rheumatica. With this approach we can confirm that prednisone may cause episodes of dyspnoea and we provide potential explanations for this side effect.
PMID: 21646673 [PubMed - in process] (Source: The Netherlands Journal of Medicine)
MedWorm: Polymyalgia Rheumatica

Conclusion: IS is decreased in PMR, probably reflecting abnormal cytokine and adipokine levels. Treatment with prednisolone improves IS along with normalization of cytokine and adipokine levels and physical activity.
PMID: 20615159 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Rheumatology)
MedWorm: Polymyalgia Rheumatica

Conclusions: US and PDUS can be useful in distinguishing, at onset of disease, pure PMR from other diseases mimicking this condition.
PMID: 20653466 [PubMed - as supplied by publisher] (Source: Scandinavian Journal of Rheumatology)
MedWorm: Polymyalgia Rheumatica

Authors: Dasgupta B,
Giant cell arteritis (GCA) or temporal arteritis (TA) with polymyalgia rheumatica (PMR) is among the most common reasons for long-term steroid prescription. GCA is a critically ischaemic disease, the most common form of vasculitis and should be treated as a medical emergency. Visual loss occurs in up to a fifth of patients, which may be preventable by prompt recognition and treatment. The British Society for Rheumatology (BSR) and the British Health Professionals in Rheumatology (BHPR) have recently published guidelines on the management of PMR. The purpose of this concise guidance is to draw attention to the full guidelines to encourage the prompt diagnosis and urgent management of GCA, with emphasis on the prevention of visual loss. They provide a framework for …
MedWorm: Polymyalgia Rheumatica

ROME — Polymyalgia rheumatica may be the presenting manifestation of silent giant cell arteritis, and therein lies a diagnostic dilemma: Which patients need a temporal artery biopsy? (Source: Rheumatology News)
MedWorm: Polymyalgia Rheumatica

ROME — A newly launched clinical trial is examining whether adrenal insufficiency contributes to the pathology of polymyalgia rheumatica. If the study yields data to support the adrenal insufficiency hypothesis, it’s quite possible that doses lower than the currently recommended 15-20 mg/day would achieve equal disease control with fewer steroid side effects, according to Dr. Marco A. Cimmino, one of the investigators. (Source: Rheumatology News)

ROME — Candidate international consensus criteria for diagnosis of polymyalgia rheumatica performed well in their first large prospective validation study. But there’s room for further improvement with tweaking of the criteria, according to Dr. Bhaskar Dasgupta, the project leader. (Source: Rheumatology News)
MedWorm: Polymyalgia Rheumatica