Polymyalgia arteritica: a clinical review

Abstract

In a series of thirty-seven consecutive patients with polymyalgia arteritica, twenty-five had polymyalgia rheumatica and twelve had cranial arteritis. Some failed to respond promptly to low doses of prednisolone and it is recommended that the initial dose should be in the order of 40 mg daily. An ESR above 40 mm in the first hour was present in four patients 3 months after admission; three were found to have rheumatoid disease and one pulmonary tuberculosis. Symptomatic relapses occurred in fourteen patients on twenty-one occasions and all responded to an increase in the daily dose of maintenance prednisolone. Most occurred in the first year and were attributable to an excessively rapid reduction in steroid therapy. Relapses occurring in patients on a stable dose of prednisolone were commonly associated with the development of rheumatoid disease. In elderly patients who have relapsed, or who have had arteritic complications, life-long prednisolone therapy appears justifiable.

Increased RAHA Titer and Interleukin-6 Levels in the Synovial Fluid in a Patient with Polymyalgia Rheumatica.

“…O'Duffy and associates reported that the correlation betweenabnormalbone scan results and the sites of muscle symptomswas so high that it suggested the myalgia might be due to the synovitis (5). Some investigators also have suggested the existence of a similarity in the pathogenesis of PMRand rheumatoid arthritis (6,7). In addition, it was demonstrated that early manifestations of rheumatoid arthritis may mimic PMR (8).…”