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Polymyalgia

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https://www.readbyqxmd.com/read/29212985/bone-formation-parameters-of-the-biopsied-ilium-differ-between-subtrochanteric-and-diaphyseal-atypical-femoral-fractures-in-bisphosphonate-treated-patients
#1
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...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29192568/-polymyalgia-rheumatica-new-developments-and-challenges
#2
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
https://www.readbyqxmd.com/read/29191375/rheumatologic-symptoms-in-oncologic-patients-on-pd-1-inhibitors
#3
Wilson F Kuswanto, Lindsey A MacFarlane, Lydia Gedmintas, Alexandra Mulloy, Toni K Choueiri, Bonnie L Bermas
OBJECTIVE: Immune checkpoint inhibitors are effective cancer therapies that have been associated with immune-related adverse events (irAEs). Recent reports of irAEs describe symptoms resembling classic rheumatologic syndromes, most notably associated with cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) inhibitor blockade. Though cases have been described, there are fewer reports of rheumatologic disease associated with programmed cell death protein-1 (PD-1) inhibitors. Here, we describe a series of four patients presenting to the Brigham and Women's Hospital (BWH) Arthritis Center with de novo polymyalgia rheumatica (PMR)-type conditions and/or peripheral synovitis after treatment with PD-1/PD-Ligand 1 (PD-L1) pathway inhibitors...
October 31, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29175873/crowned-dens-syndrome
#4
David Ledingham, Cecilia Cappelen-Smith, Dennis Cordato
Crowned dens syndrome is a rare presentation of calcium pyrophosphate deposition disease. It is characterised by severe occipital pain and neck stiffness. Acute presentations are typically accompanied by fever and an inflammatory response and hence can be misdiagnosed as polymyalgia rheumatica or meningitis. Chronic relapsing presentations may be misdiagnosed as cervicogenic neck pain or occipital neuralgia. We present a patient who presented with a chronic relapsing form of crowned dens syndrome and discuss the epidemiology, typical presentation and management of this eminently treatable condition...
November 24, 2017: Practical Neurology
https://www.readbyqxmd.com/read/29166756/use-of-imaging-techniques-in-large-vessel-vasculitis-and-related-conditions
#5
Annibale Versari, Nicolò Pipitone, Massimiliano Casali, Francois Jamar, Giulia Pazzola
Giant Cell Arteritis (GCA) and Takayasu's arteritis (TA) are large vessel vasculitis (LVV) primarily affecting the aorta and its major branches, mainly differentiated by the onset age (>50 years GCA and <40 years TA). In addition, temporal artery involvement and polymyalgia rheumatic are typical features of GCA, but not TA. Imaging techniques are required to secure the diagnosis of large-vessel vasculitides, and to monitor the disease course. Both morphological and metabolic imaging are involved. Morphological imaging is represented mainly by Computerized Tomography (CT), CT angiography, Magnetic Resonance (MR), MR angiography, Color-Doppler Sonography (CDS) and high-resolution CDS...
November 22, 2017: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29146737/rheumatic-disorders-associated-with-immune-checkpoint-inhibitors-in-patients-with-cancer-clinical-aspects-and-relationship-with-tumour-response-a-single-centre-prospective-cohort-study
#6
Marie Kostine, Léa Rouxel, Thomas Barnetche, Rémi Veillon, Florent Martin, Caroline Dutriaux, Léa Dousset, Anne Pham-Ledard, Sorilla Prey, Marie Beylot-Barry, Amaury Daste, Marine Gross-Goupil, Julie Lallier, Alain Ravaud, Edouard Forcade, Bernard Bannwarth, Marie-Elise Truchetet, Christophe Richez, Nadia Mehsen, Thierry Schaeverbeke
OBJECTIVES: To evaluate the prevalence and type of rheumatic immune-related adverse events (irAEs) in patients receiving immune checkpoint inhibitors (ICIs), as well as the correlation with tumour response. METHODS: This was a single-centre prospective observational study including all cancer patients receiving ICIs. The occurrence of irAEs and tumour response was assessed on a regular basis. Patients who experienced musculoskeletal symptoms were referred to the department of rheumatology for clinical evaluation and management...
November 16, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29136209/use-of-18f-fluorodeoxyglucose-positron-emission-tomography-in-the-diagnosis-of-polymyalgia-rheumatica-a-prospective-study-of-99-patients
#7
Liesbet Henckaerts, Olivier Gheysens, Steven Vanderschueren, Karolien Goffin, Daniel Blockmans
Objective: Previous studies have shown that the majority of patients with PMR have increased 18F-fluorodeoxyglucose (FDG) uptake around the shoulders, hips and processes of the cervical and lumbar spine on PET. The specificity of these findings for PMR is, however, not known. Methods: We prospectively included 99 consecutive patients with a possible clinical diagnosis of PMR. All patients underwent 18F-FDG-PET scanning before treatment with glucocorticoids was started...
October 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/29124397/long-term-glucocorticoid-treatment-in-patients-with-polymyalgia-rheumatica-giant-cell-arteritis-or-both-diseases-results-from-a-national-rheumatology-database
#8
Katinka Albrecht, Dörte Huscher, Frank Buttgereit, Martin Aringer, Guido Hoese, Wolfgang Ochs, Katja Thiele, Angela Zink
The objective of this study was to evaluate glucocorticoid (GC) use in patients with polymyalgia rheumatica (PMR), giant cell arteritis (GCA) or both diseases (PMR + GCA) under rheumatological care. Data from patients with PMR (n = 1420), GCA (n = 177) or PMR + GCA (n = 261) from the National Database of the German Collaborative Arthritis Centers were analyzed regarding GCs and related comorbidities (osteoporosis, diabetes and cardiovascular disease), stratified by disease duration (DD). Longitudinal data were analyzed for all patients with a DD ≤ 2 years at database entry (n = 1397)...
November 9, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29122897/polymyalgia-rheumatica-development-in-a-patient-under-pi3k-inhibitor-therapy-for-chronic-lymphocytic-leukaemia
#9
Sanah Sajawal, Sarah L Mackie, Peter Hillmen, Dennis McGonagle
We report a patient with chronic lymphocytic leukaemia (CLL) who was treated with idelalisib, a PI3Kδ inhibitor with rituximab. After 20 weeks of treatment, the patient developed classical signs and symptoms of polymyalgia rheumatica (PMR) in association with an elevated C reactive protein of 74 mg/L. After 2 weeks of prednisolone 15 mg daily symptoms had resolved and acute phase markers normalised. To our knowledge, this is the first report of PMR developing as a complication of PI3Kδ inhibitor treatment of CLL...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29121248/fusion-of-positron-emission-tomography-computed-tomography-with-magnetic-resonance-imaging-reveals-hamstring-peritendonitis-in-polymyalgia-rheumatica
#10
Claire E Owen, Aurora M T Poon, Sze Ting Lee, Lee Pheng Yap, Richard B Zwar, Christine M McMenamin, Simon K L Lam, David F L Liew, Kunthi Pathmaraj, Andrew Kemp, Andrew M Scott, Russell R C Buchanan
Objectives: To characterize 18F-fluorodeoxyglucose (18F-FDG) uptake on whole-body PET/CT in PMR, and identify its precise anatomic correlate using MRI. Methods: Patients with newly diagnosed PMR according to the 2012 EULAR/ACR classification criteria were prospectively recruited. Participants with GCA were excluded. A whole-body 18F-FDG PET/CT scan was performed in all untreated patients. Qualitative and semiquantitative [standardized uptake value maximum (SUVmax)] scoring of abnormal 18F-FDG uptake was undertaken...
November 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/29118757/decreased-immunity-to-varicella-zoster-virus-in-giant-cell-arteritis
#11
Christien Rondaan, Kornelis S M van der Geest, Elisabeth Eelsing, Annemieke M H Boots, Nicolaas A Bos, Johanna Westra, Elisabeth Brouwer
Introduction: Herpes zoster, which can have a major impact on quality of life, results from reactivation of a latent varicella zoster virus (VZV) infection. We hypothesized that giant cell arteritis (GCA) patients are at increased risk of herpes zoster because of treatment with high-dose glucocorticoids and advanced age. Aim of the study, therefore, was to determine cell-mediated and humoral immunity to VZV in patients with GCA, patients with closely related disease polymyalgia rheumatica (PMR; treated with lower doses of glucocorticoids) and healthy controls (HCs)...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/29088976/incidence-of-rheumatoid-arthritis-psoriatic-arthritis-and-polymyalgia-rheumatica-in-an-inland-area-of-central-italy-results-of-the-campo-rhe-study
#12
Antonia De Socio, Fabio Massimo Perrotta, Guido Maria Grasso, Ennio Lubrano
OBJECTIVE: The aim of the CAMPO-RHE study was to determine the incidence of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and polymyalgia rheumatica (PMR) in patients attending a rheumatologic outpatient's clinic of a new institution in Campobasso, Italy. METHODS: Campobasso is a small town of approximately 50,000 inhabitants located in the inland territory of central Italy (Molise), and Public Health is managed from a single health authority. In Italy, all citizens are registered with a National Health System of General Practitioner (GP) Physicians...
November 3, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29043142/costimulation-pathway-blockade-in-kidney-transplant-recipients-with-de-novo-rheumatoid-arthritis
#13
Mohamed Sheta, Samy Riad, Udayakumar Deepak, Naim Issa, Mark Birkenbach, Hassan N Ibrahim, Aleksandra Kukla
The best approach to treatment of de-novo rheumatoid arthritis in solid organ transplant recipients on typical immunosuppression is not well established. The use of biologics targeting specific cell types, cytokines, and immunological pathways has been gaining interest in the treatment of both, auto- and alloimmunity. We present a case of de-novo rheumatoid arthritis in a kidney transplant recipient 10 years post-transplant while receiving cyclosporine, mycophenolate mofetil, and also prednisone. Initial presentation included features of polymyalgia rheumatica and nephrotic range proteinuria...
2017: Clinical Nephrology. Case Studies
https://www.readbyqxmd.com/read/29020715/diagnosis-and-management-of-polymyalgia-rheumatica
#14
REVIEW
Olwyn Jones, Fraser Birrell
Polymyalgia rheumatica (PMR) is a common inflammatory condition of unknown aetiology with a prevalence of 1 in 133 in the over 50s, and a female to male ratio of 2:1. Symptoms develop over a matter of weeks; typically bilateral shoulder or pelvic girdle pain and stiffness, that is worse in the mornings. Associated symptoms include low-grade fever, malaise, fatigue, low mood, poor appetite, and weight loss. There is no specific diagnostic test for PMR but the usual pattern is a commensurate rise in CRP and ESR...
December 2016: Practitioner
https://www.readbyqxmd.com/read/28994265/recognition-of-giant-cell-arteritis-in-patients-with-polymyalgia-rheumatica-who-have-a-stroke-a-cautionary-tale
#15
Donald H Gutteridge, Frank L Mastaglia
An 82-year-old woman with polymyalgia rheumatica (PMR) on prednisone 7 mg daily was admitted to an acute stroke unit with a right homonymous hemianopia, a left posterior cerebral artery occlusion and occipital lobe infarct. She had raised inflammatory markers, did not have a temporal artery biopsy, and was discharged on the same dose of prednisone. After 21 months, off prednisone, her ophthalmologist, concerned about giant cell arteritis (GCA), restarted prednisone 40 mg daily, with rapid, profound visual improvement...
October 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28975885/pet-ct-findings-in-patients-with-polymyalgia-rheumatica-without-symptoms-of-cranial-ischaemia
#16
Alexander Lund-Petersen, Anne Voss, Helle Laustrup
INTRODUCTION: Polymyalgia rheumatica (PMR) is an inflammatory disorder that affects the elderly. At present, evidence is limited regarding the usefulness of positron emission tomography-computed tomography (PET-CT) in the diagnosis of PMR. This study aimed to compare patient characteristics and symptoms with PET-CT findings in a Danish population of PMR patients without clinical symptoms of giant cell arteritis. METHODS: The medical records of 50 Danish PET-CT-scanned patients with PMR were reviewed...
October 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28970729/patients-with-inflammatory-bowel-disease-have-increased-risk-of-autoimmune-and-inflammatory-diseases
#17
Morten L Halling, Jens Kjeldsen, Torben Knudsen, Jan Nielsen, Lars Koch Hansen
AIM: To investigate whether immune mediated diseases (IMD) are more frequent in patients with inflammatory bowel disease (IBD). METHODS: In this population based registry study, a total of 47325 patients with IBD were alive and registered in the Danish National Patient Registry on December 16, 2013. Controls were randomly selected from the Danish Civil Registration System (CRS) and matched for sex, age, and municipality. We used ICD 10 codes to identify the diagnoses of the included patients...
September 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28968513/prevalences-of-autoimmune-diseases-in-schizophrenia-bipolar-i-and-ii-disorder-and-controls
#18
Laura Cremaschi, Mathias Kardell, Viktoria Johansson, Anniella Isgren, Carl M Sellgren, A Carlo Altamura, Christina M Hultman, Mikael Landén
Previous studies on the relationship between autoimmune diseases, schizophrenia, and bipolar disorder are mainly based on hospital discharge registers with insufficient coverage of outpatient data. Furthermore, data is scant on the prevalence of autoimmune diseases in bipolar subgroups. Here we estimate the self-reported prevalences of autoimmune diseases in schizophrenia, bipolar disorder type I and II, and controls. Lifetime prevalence of autoimmune diseases was assessed through a structured interview in a sample of 9076 patients (schizophrenia N = 5278, bipolar disorder type I N = 1952, type II N = 1846) and 6485 controls...
December 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28948949/diagnosis-of-polymyalgia-rheumatica-usually-means-a-favourable-outcome-for-your-patient
#19
REVIEW
Marcin Milchert, Marek Brzosko
Polymyalgia rheumatica (PMR) is a unique disease of elderly people, traditionally diagnosed based on a clinical picture. A typical case is a combination of severe musculoskeletal symptoms and systemic inflammatory response with spectacular response to corticosteroids treatment. The severity of symptoms may be surprising in older patients where immunosenescence is normally expected. However, PMR may be diagnosed in haste if there is a temptation to use this diagnosis as a shortcut to achieve rapid therapeutic success...
May 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28928271/the-value-of-18f-fdg-pet-ct-in-identifying-the-cause-of-fever-of-unknown-origin-fuo-and-inflammation-of-unknown-origin-iuo-data-from-a-prospective-study
#20
Verena Schönau, Kristin Vogel, Matthias Englbrecht, Jochen Wacker, Daniela Schmidt, Bernhard Manger, Torsten Kuwert, Georg Schett
BACKGROUND: Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are diagnostically challenging conditions. Diagnosis of underlying disease may be improved by 18F-fluorodesoxyglucose positron emission tomography (18F-FDG-PET). METHODS: Prospective study to test diagnostic utility of 18F-FDG-PET/CT in a large cohort of patients with FUO or IUO and to define parameters that increase the likelihood of diagnostic 18F-FDG-PET/CT. Patients with FUO or IUO received 18F-FDG-PET/CT scanning in addition to standard diagnostic work-up...
September 19, 2017: Annals of the Rheumatic Diseases
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