POLYMYALGIA RHEUMATICA
GAINT CELL ARTERITIS*Common in elderly
*Age ; over 50*Close association PMR/GCA
*F/M 4/1
PMR
Clinical features:
- Sever pain & stiffness of neck, back ,shoulder ,upper arms & thigh, with profound & prolong M.S
-Slight tenderness of acromioclavicular & sternoclav. Jt. with mild inflam. Arthritis .
-Associated with cranial arteritis &arterial tenderness in 1/3 of pat.
-No association with myositis
Lab. Findings:
*ESR markedly elevated
*Normochromic normocytic anemia
*Temporal art. Biopsy +ve in 15-40% of PMR
Treatment:
-The response to steroid is dramatic so used for therapeutic & diagnostic purposes.
-Prednisonolone 15mg/day ; Diagnosis should reviewed if no striking remission within week.
-Tapering of the dose 4-8wks. After starting treatment.
-Maintenance dose in cl. Remission 5-7mg of prednisone. For 2y.
-Prophylactic Ca supplement
-Azothioprine as steroid sparing maneuver in those who need high dose of steroid.
Ideal Group
A.H.Yahia