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Polymyalgia rheumatica and thyroid papillary carcinoma

M Tabata1, T Kobayashi

  • 1Tabata Clinic, Kyoto.

Internal Medicine (Tokyo, Japan)
|January 1, 1994
PubMed
Summary

Polymyalgia rheumatica (PMR) symptoms and altered lymphocyte responses improved with corticosteroid treatment. This suggests PMR may be a paraneoplastic syndrome linked to thyroid cancer impacting cell-mediated immunity.

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Area of Science:

  • Immunology
  • Rheumatology
  • Oncology

Background:

  • Polymyalgia rheumatica (PMR) is an inflammatory condition often associated with other autoimmune or neoplastic processes.
  • Thyroid papillary carcinoma is a common endocrine malignancy.

Observation:

  • A 64-year-old woman presented with polymyalgia rheumatica (PMR) and concurrent thyroid papillary carcinoma.
  • Elevated peripheral blood lymphocyte responses to mitogens were observed during PMR exacerbations.
  • These responses normalized following short-term corticosteroid treatment, coinciding with PMR symptom resolution.

Findings:

  • The patient's PMR symptoms and abnormal lymphocyte reactivity resolved after treatment for thyroid cancer.
  • Lymphocyte responses returned to control levels nine months after metastatic lymph node removal.
  • These findings suggest a potential link between the thyroid tumor, impaired cell-mediated immunity, and PMR development.

Implications:

  • PMR may manifest as a paraneoplastic syndrome in the context of thyroid papillary carcinoma.
  • Monitoring immune function in patients with PMR and concurrent malignancies could be beneficial.
  • This case highlights the complex interplay between cancer, immunity, and inflammatory conditions.

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