Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are two related and immune-mediated inflammatory conditions that occur in the elderly. PMR coexists in 40% of patients with GCA. Similarly, 10% of PMR patients develop GCA at some point during their disease course. Most patients describe a subacute onset of symptoms that remain persistent over time. The most common symptom (reported in 70% to 95% of patients) is symmetrical shoulder girdle pain and stiffness. Fifty percent to 70% report neck and pelvic girdle pain. Concurrent pain in the upper arms and thighs is common and is usually worse in the morning. Shoulder and leg discomfort can lead to difficulty dressing, hair grooming, and rising from a chair. One third of patients have flu like symptoms described as fever, malaise, anorexia, or weight loss.
HOW IS POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS DIAGNOSED?
A General Physician/Rheumatologist diagnoses Polymyalgia Rheumatica and Giant Cell Arteritis by conducting a physical examination and blood test to check for signs of inflammation in the body. In certain cases, the doctor may schedule an ultrasound to check for inflammation in the joints and tissues and biopsy.
HOW IS POLYMYALGIA RHEUMATICA AND GIANT CELL ARTERITIS TREATED?
Prednisone or prednisolone is the most commonly used corticosteroids. Starting doses range from 15 mg to 20 mg per day. A dramatic response to therapy with near-total relief of symptoms should occur within 1 to 5 days. Lack of a dramatic response to corticosteroids should prompt physicians to reconsider the diagnosis. A gradual decline of the acute-phase reactants should be expected but should never be the sole gauge of therapy. After an adequate response to corticosteroids has been achieved, the initial dose should be maintained for 1 month before beginning a slow taper to the lowest effective dose. One to 2 years of treatment with corticosteroids should be expected, and a few patients require low-dose prednisone for several years.
DID YOU KNOW?
This is not a very serious disease and even without the symptoms tend to disappear within a year or longer. But it does lead to discomfort and pain throughout the tenure, making life a bit tough.