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Pleuropericardial effusion: an unusual presentation of polymyalgia rheumatica

Lovely Chhabra1, Ramprakash Devadoss2, Karthik Gnanapandithan3

  • 1Hartford Hospital, University of Connecticut School of Medicine, Hartford, Connecticut, USA.

BMJ Case Reports
|June 1, 2014
PubMed

Insights

Polymyalgia rheumatica (PMR), a condition causing muscle stiffness, rarely presents with serositis. This case highlights PMR with a primary pleuropericardial syndrome, a highly unusual manifestation.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Systemic Inflammatory Conditions

Background:

  • Polymyalgia rheumatica (PMR) is characterized by proximal muscle aches and stiffness.
  • It is an idiopathic systemic inflammatory disorder.
  • PMR is typically associated with elevated inflammatory markers.

Observation:

  • This report details an exceptionally rare presentation of PMR.
  • The patient's primary clinical manifestation was pleuropericardial syndrome, specifically a pleuropericardial effusion.
  • This contrasts with the usual musculoskeletal symptoms of PMR.

Findings:

  • The case demonstrates that polymyalgia rheumatica can manifest initially with serositis, specifically pleuropericardial effusion.
  • This finding expands the known spectrum of PMR presentations.
  • The diagnosis of PMR was established despite the atypical initial symptoms.

Implications:

  • This case underscores the importance of considering PMR in patients presenting with unexplained serositis, even without typical musculoskeletal symptoms.
  • It suggests that pleuropericardial syndromes may be an under-recognized, rare manifestation of polymyalgia rheumatica.
  • Further investigation into the association between PMR and serositis may be warranted.

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