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Polymyalgia rheumatica

Lana Yin Hui Lai, Emma Harris, Robert M West, Sarah Louise Mackie
Background: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are almost always treated with glucocorticoids (GCs), but long-term GC use is associated with diabetes mellitus (DM). The absolute incidence of this complication in this patient group remains unclear. Objective: To quantify the absolute risk of GC-induced DM in PMR and GCA from published literature. Methods: We identified literature from inception to February 2017 reporting diabetes following exposure to oral GC in patients with PMR and/or GCA without pre-existing diabetes...
2018: RMD Open
Shingo Suzuki, Yuta Hirose, Eriko Takeda, Masatomi Ikusaka
No abstract text is available yet for this article.
February 21, 2018: American Journal of Medicine
David Castro Corredor, Marco Aurelio Ramírez Huaranga, Ana Isabel Rebollo Giménez, Rocío Arenal López, José Luis Cuadra Díaz
OBJECTIVE: To describe the different clinical characteristics of patients admitted to the Rheumatology Department due to rheumatic manifestations as the first expression of an unknown malignant process. PATIENTS AND METHODS: Retrospective and descriptive observational study involving the review of the medical records of those admitted to rheumatology in the University Hospital of Ciudad Real between January 2007 and August 2017 for initial rheumatic manifestations with a suspicion at discharge of an unknown tumor...
February 15, 2018: Reumatología Clinica
Ali Aydeniz, Mazlum Serdar Akaltun, Ali Gür, Savaş Gürsoy
Ankylosing spondylitis is a chronic inflammatory disease that affects the spine and peripheral joints. Polymyalgia rheumatica is an inflammatory disease characterized by aching and prolonged morning stiffness mainly in the shoulder and pelvic girdles. Many other diseases may mimic polymyalgia rheumatica, and thus differential diagnosis is predominantly required. A wide variety of diseases, including spondyloarthropathies, may present polymyalgia-like symptoms, and two diseases rarely coexist. We present a case of a 54-year-old man who had been followed-up for ankylosing spondylitis and presented with pain in the shoulder and pelvic girdles, restricted movement, and morning stiffness for 2 months...
January 2018: Aǧrı: Ağrı (Algoloji) Derneği'nin Yayın Organıdır, the Journal of the Turkish Society of Algology
Anish Chandrasekar, Elizabeth M A Hensor, Sarah L Mackie, Michael R Backhouse, Emma Harris
BACKGROUND: Activity monitors provide objective measurements of physical activity, however, the accuracy of these devices in people with polymyalgia rheumatica (PMR) is unknown. Therefore, this study aimed to obtain preliminary evidence of the accuracy of two activity monitors and explore if clinical and gait-related factors altered device accuracy in people with PMR. METHODS: The ActiGraph with low frequency extension (+LFE) and standard (-LFE) algorithms, Fitbit-Zip (waist) and Fitbit-Zip (shirt) were concurrently tested using a two-minute walk test (2MWT) and stairs test in 27 people with PMR currently treated with prednisolone...
January 31, 2018: Gait & Posture
Hubert de Boysson, Aurélie Daumas, Mathieu Vautier, Jean-Jacques Parienti, Eric Liozon, Marc Lambert, Maxime Samson, Mikael Ebba, Anael Dumont, Audrey Sultan, Bernard Bonnotte, Alain Manrique, Boris Bienvenu, David Saadoun, Achille Aouba
OBJECTIVES: Large-vessel involvement (LVI) can occur in giant-cell arteritis (GCA) and may represent a distinct disease subgroup with a higher risk for aortic dilation. This study aimed to better characterize the presentation and evolution of LVI in patients with GCA. PATIENTS AND METHODS: A retrospective multicenter study enrolled 248 GCA patients with LVI and 301 GCA patients without LVI on imaging. Factors associated with aortic dilation were identified in a multivariable model...
February 7, 2018: Autoimmunity Reviews
Isabel Castrejon, Annie Huang, Sarah L Everakes, Ailda Nika, Winston Sequeira
No abstract text is available yet for this article.
February 7, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Ronen Blecher, Emre Yilmaz, Tamir Tawfik, Amir Abdul-Jabbar, Thomas O'Lynnger, Marc Moisi, Robert Hart, David Hanscom, Rod J Oskouian, R Shane Tubbs, Jens Chapman
The authors describe a 48-year-old woman suffering from bilateral upper-extremity numbness and axial radiating pain. Magnetic resonance imaging revealed soft-tissue edema and enhancement surrounding the dorsal tip of the C7 spinous process. Excisional biopsy of the lesion revealed a mildly inflamed bursa, with no evidence of an active infection. Removal of the inflamed bursa resulted in complete resolution of the upper-extremity numbness and improvement in her neck pain. Although similar cases have been reported to be associated with rheumatologic conditions, most notably polymyalgia rheumatica (PMR), the current report underlines the presentation of radicular-like complaints associated with interspinous bursitis in the absence of other conditions affecting the musculoskeleton...
November 30, 2017: Curēus
Sarah Péricart, Guillaume Martin-Blondel, Camille Franchet, Anne Hitzel, Pierre Brousset
RATIONALE: Follicular Lymphoma in situ is generally identified as reactive follicular hyperplasia in which some of the hyperplastic germinal centers are colonized by few lymphoma cells. These cells can be detected through their strong 18F-Fluorodeoxyglucose avidity. PATIENT CONCERNS: We report the case of a 70 year-old patient with arthralgia, weight loss and chronic fever over two months. A paraneoplastic polymyalgia rheumatica was initially suspected on abnormal 18F fluoro-deoxyglucose positron emission tomography (PET) pictures in two inguinal lymph nodes with a standardized uptake value at 8...
November 2017: Medicine (Baltimore)
Aline Charpentier, Frank Verhoeven, Maxime Sondag, Xavier Guillot, Clément Prati, Daniel Wendling
The aim of this study was to evaluate the impact of age on the therapeutic response to prednisone. This was a retrospective, monocentric study. We included patients diagnosed with PMR, according to ACR 2012 criteria. Patients were classified into two groups according to age (above or below 60 years old). We registered demographic, clinical, biological, imaging data, and therapeutic response profile. Local inflammation was evaluated at baseline with PET/CT imaging score. The treatment was standardised. The main endpoint was a corticosteroid dependence defined by the recurrence of PMR symptoms and/or the increase of CRP at two times...
January 29, 2018: Clinical Rheumatology
Anaïs Huwart, Florent Garrigues, Sandrine Jousse-Joulin, Thierry Marhadour, Dewi Guellec, Divi Cornec, Maelenn Gouillou, Alain Saraux, Valérie Devauchelle-Pensec
BACKGROUND: This study assessed inflammatory changes using ultrasound (US) and magnetic resonance imaging (MRI) in patients taking tocilizumab for polymyalgia rheumatica (PMR). METHODS: Eighteen patients were included in the prospective open-label TENOR study and received three tocilizumab infusions, without corticosteroids. B-mode and power Doppler US and MRI (T1 and T2-short time inversion recuperation weighted sequences) of the hips and shoulders were performed at weeks 0, 2, and 12...
January 25, 2018: Arthritis Research & Therapy
Michael D Richter, Olga Pinkston, Lisa A Kottschade, Heidi D Finnes, Svetomir N Markovic, Uma Thanarajasingam
OBJECTIVES: To determine the risk of rheumatologic disease flare and adverse effects in patients with preexisting rheumatologic disease receiving checkpoint inhibitor therapy. METHODS: A retrospective medical record review was performed to identify all patients who received checkpoint inhibitor therapy at Mayo Clinic, Rochester between 2011 and 2016 (approximately 5,200 patients). Those with preexisting rheumatologic disease were identified using specific diagnostic codes...
January 24, 2018: Arthritis & Rheumatology
M Kobayashi, H Shimojo, K Shingu, M Harada, H Kanno
No abstract text is available yet for this article.
January 23, 2018: Scandinavian Journal of Rheumatology
Valérie Devauchelle-Pensec, Lea Saraux, Jean Marie Berthelot, Michel De Bandt, Divi Cornec, Dewi Guellec, Thierry Marhadour, Sandrine Jousse-Joulin, Maelenn Gouillou, Alain Saraux
Objective: The PMR activity score (PMR-AS) includes the CRP value, which may be lacking or invalid owing to anti-IL-6 therapy. Our objective was to develop alternatives to PMR-AS that do not require CRP. Methods: We used the Club Rhumatisme et Inflammation (CRI; 89 patients with PMR) and the Tolerance and Efficacy of tocilizumab iN pOlymyalgia Rheumatica (TENOR; 20 patients with recent-onset PMR naive to glucocorticoid who received three tocilizumab infusions, at weeks 0, 4 and 8, followed by prednisone from weeks 12 to 24) cohorts...
January 15, 2018: Rheumatology
Alison H Clifford, Marco A Cimmino
No abstract text is available yet for this article.
January 11, 2018: Rheumatology
Pietro Enea Lazzerini, Iacopo Bertolozzi, Maurizio Acampa, Rosella Fulceri, Franco Laghi-Pasini, Pier Leopoldo Capecchi
Polymyalgia rheumatica (PMR) represents the most common inflammatory rheumatic disease of the elderly. It is characterized by synovitis of proximal joints and extra-articular synovial structures, along with chronic high-grade systemic inflammation. PMR is closely related to giant cell arteritis (GCA), a large-vessel vasculitis that involves the major branches of the aorta, particularly the extracranial branches of carotid artery including temporal arteries. It is currently believed that PMR and GCA may represent different manifestations of the same disease process...
January 10, 2018: Current Pharmaceutical Design
Zoe Paskins, Rebecca Whittle, Alyshah Abdul Sultan, Sara Muller, Milica Blagojevic-Bucknall, Toby Helliwell, Samantha Hider, Edward Roddy, Christian Mallen
BACKGROUND: Glucocorticoids are associated with increased fracture risk and are the mainstay of treatment in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). However, fracture risk in these conditions has not been previously quantified. The aim of this study was to quantify the risk of fracture among patients with PMR and GCA. METHODS: A retrospective cohort study was conducted using primary care records from the UK-based Clinical Practice Research Datalink...
January 10, 2018: BMC Medicine
Takeshi Suzuki, Ryochi Yoshida, Yuka Hidaka, Yu Seri
Semiquantitative scoring for subacromial bursa (SAB), subdeltoid bursa (SDB), and subcoracoid bursa by both gray-scale (GS) and power Doppler (PD) ultrasonography was performed in 15 patients with polymyalgia rheumatica (PMR) (72.6 ± 7.7 years old) and 15 patients with elderly onset rheumatoid arthritis with PMR-like onset (pm-EORA) (70.7 ± 7.0 years old) before starting treatment. The GS grades of SAB were significantly higher in the shoulders with pm-EORA than in the shoulders with PMR. The GS and PD scores of SAB and the PD scores of SDB were significantly higher in pm-EORA than in PMR cases...
2017: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
Naoki Kondo, Tomomi Fukuhara, Yo Watanabe, Dai Miyasaka, Noriaki Yamamoto, Hiroe Sato, Yoko Wada, Takeshi Nakatsue, Junichi Fujisawa, Mayumi Sakuma, Norio Imai, Takuya Yoda, Ichiei Narita, Naoto Endo
Atypical femoral fractures (AFFs) are defined as atraumatic or low-trauma fractures located in the subtrochanteric or diaphyseal sites. Long-term bisphosphonates (BPs) are administered to prevent fragility fractures in patients with primary osteoporosis or collagen diseases who are already taking glucocorticoids (GCs). Long-term BP use is one of the most important risk factors for AFFs. Its pathogenesis is characterized by severely suppressed bone turnover (SSBT), but whether the characteristics of patients are different regarding to location of fracture site remains unknown...
December 2017: Tohoku Journal of Experimental Medicine
D E Marsman, A A den Broeder, N Boers, A van der Maas
- Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disorder in which inflammation markers, both erythrocyte sedimentation rate (ESR) and CRP values, are often elevated. However, a non-abnormal ESR or CRP value does not preclude the diagnosis.- PMR is an arbitrary diagnosis and presents both diagnostic and therapeutic challenges.- Imaging diagnostics, such as echography, MRI or FDG-PET/CT, may potentially be applied more frequently as a second-line investigation when there is doubt concerning the diagnosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
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