Relapse of polymyalgia rheumatica after a fall

Area of Science:

• Rheumatology
• Internal Medicine
• Geriatrics

Background:

• Polymyalgia Rheumatica (PMR) frequently involves relapses, often requiring glucocorticosteroid (GC) dose adjustments.
• The influence of external factors, such as falls, on PMR relapse is not well understood.

Purpose of the Study:

• To investigate the potential link between falls and Polymyalgia Rheumatica (PMR) relapse.
• To analyze characteristics of PMR patients experiencing relapse after a fall.

Main Methods:

• A case-series of five PMR patients who relapsed after a fall was presented.
• PMR relapse was assessed using the PMR-AS score (>9.35).
• Demographic and GC data were compared between relapsed and non-relapsed patients using Fischer's exact test.

Main Results:

• Five PMR patients experienced relapse immediately following a fall, marked by increased inflammatory indices.
• GC dose escalation (prednisone ~10 mg/day) rapidly resolved symptoms within seven days.
• No significant differences in age, sex, or cumulative GC dose were found between relapsed and non-relapsed groups.

Conclusions:

• Falls should be considered a potential trigger for Polymyalgia Rheumatica (PMR) relapse in clinical practice.
• Further multicentric studies are needed to confirm these findings and explore underlying mechanisms.
• Assessing fall risk may become crucial for managing PMR patients.