Polymyalgia Rheumatica Research[Polymyalgia rheumatica.]Primary Author: C DuftnerPrimary Author: Abteilung für Innere Medizin, Krankenhaus der Elisabethinen, Völkermarkterstrasse 15-19, 9020, Klagenfurt, Osterreich.Date Published: 2008 12 22Abstract: Polymyalgia rheumatica (PMR) is a common chronic inflammatory rheumatic disease with unknown aetiology, affecting predominately people of middle age and older. Besides clinical symptoms and diagnostics, imaging techniques including sonography and magnetic resonance imaging may provide evidence of typical inflammatory lesions with bilateral bursitis subdeltoidea or subacromialis, tenosynovitis of the biceps tendon sheath and/or synovitis of the shoulder joints and thus may support the diagnosis of this disease in difficult cases. Corticosteroids are the cornerstone of treatment of PMR, but adverse events because of chronic corticosteroid use are observed in more than 50% of treated patients. Whether immunosuppressants, such as methotrexate and tumour necrosis factor-alpha inhibitors are effective in the therapy of PMR has still not yet been clarified.
Procalcitonin at the onset of giant cell arteritis and polymyalgia rheumatica: the GRACG prospective study.Primary Author: J SchmidtPrimary Author: Department of Internal Medicine and RECIF, Laboratory of Biochemistry, Department of Pathology and Biobank of Picardie, Amiens University Hospital, Amiens, France.Date Published: 2008 12 22Abstract: Objectives. An epidemic pattern has been reported for GCA and PMR. Immunological studies have shown that an unknown antigen activates the dendritic cells of the adventitia and the type 4 toll-like receptors. Procalcitonin (PCT) is an early marker of bacterial infection. The goal of the study was to assess the level of PCT in GCA and PMR at the onset of the disease. Methods. Patients diagnosed during the 2002-06 period were randomly selected. All the 46 patients fulfilled the ACR or the Hunder criteria, and all blood samples were taken before steroid therapy. Results. PCT was normal in all patients. PCT was slightly increased in men (0.087 +/- 0.023 mug/l) compared with women (0.066 +/- 0.027 mug/l) (P = 0.009), and in PMR (0.092 +/- 0.027mug/l) compared with GCA (0.068 +/- 0.026 mug/l) (P = 0.018). There was no significant correlation with inflammation markers. Conclusions. These results are not in favour of a bacterial trigger for GCA or PMR. Increased PCT levels in patients with inflammatory syndrome, GCA-PMR symptoms and negative temporal artery biopsy may rule out the diagnosis of GCA and PMR.
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