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Polymyalgia rheumatica.

E S McCabe

    Journal of the American Geriatrics Society
    |February 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Polymyalgia rheumatica in the elderly presents with constitutional symptoms and elevated erythrocyte sedimentation rate (ESR). Prednisone effectively treats symptoms and lowers ESR, unlike other medications.

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    Area of Science:

    • Rheumatology
    • Internal Medicine

    Background:

    • Polymyalgia rheumatica (PMR) is a common inflammatory condition in the elderly.
    • Constitutional symptoms like weight loss, fever, fatigue, and proximal muscle weakness are characteristic of PMR.

    Observation:

    • Giant-cell arteritis (GCA) is a related condition that may develop later.
    • Temporal artery biopsy is crucial for diagnosing GCA and guiding therapy.
    • An elevated erythrocyte sedimentation rate (ESR) is a key diagnostic indicator, often exceeding 80 mm/hour.

    Findings:

    • While salicylates and NSAIDs offer some relief, they do not normalize ESR or prevent relapses.
    • Prednisone demonstrates significant efficacy in improving clinical symptoms and reducing elevated ESR.
    • Potassium p-aminobenzoate may aid in maintaining remission after initial treatment.

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    Implications:

    • Early consideration of PMR in elderly patients with constitutional symptoms is vital.
    • Distinguishing PMR from GCA and appropriate diagnostic testing (ESR, biopsy) are essential.
    • Corticosteroid therapy, particularly prednisone, is the cornerstone for managing PMR and associated GCA.