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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two elderly patients presented with generalized aches and pains (particularly in the shoulders and the pelvic girdle), stiffness, fatigue, anemia, and an elevated erythrocyte sedimentation rate, but there were no signs or symptoms directly referable to the joints. Two and five months later respectively, pain, swelling, and signs of synovitis appeared in several joints in a symmetrical pattern, and a diagnosis of rheumatoid arthritis was made. Rheumatoid arthritis in the elderly may resemble polymyalgia rheumatica. On the other hand, synovitis in many patients with polymyalgia rheumatica may resemble rheumatoid arthritis. In the elderly, the differentiation of these two entities may be difficult. Moreover, patients initially presenting with the signs and symptoms of polymyalgia may eventually manifest typical rheumatoid arthritis.
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PMID:Rheumatoid arthritis in the elderly, presenting as polymyalgia rheumatica. 42 38

A 79-year old female patient with antecedents of headache and fever, was admitted because of fatigue, anorexia, anemia and elevated ESR. After admission she presented with rheumatic polymyalgia and synovial effusion in the knee. A first biopsy of the temporal artery was normal. After dismissing other possible causes a second biopsy of the contralateral temporal artery was bone and confirmed giant cell arteritis. Diagnostic value of a second temporal artery biopsy is discussed and justified by: a) a confirmed diagnosis is necessary for prolonged treatment with corticosteroids, b) if it is decided to treat the rheumatic polymyalgia with lower doses of corticosteroids than for temporal arteritis the certainty that no temporal arteritis is present and c) shortening the hospital stay and lowering the cost and number of diagnostic procedures. The frequency of arthritis and synovial effusion in temporal arteritis are also discussed.
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PMID:[Giant cell arteritis: diagnostic value of a second biopsy of the temporal artery (author's transl)]. 724 67

Cranial arteritis (CA), also called giant cell arteritis or temporal arteritis, is a vasculitis primarily affecting adults over age 50. It is a large vessel vasculitis, and giant cells classically can be identified on histopathologic examination of temporal arteries, but are not essential for diagnosis. Patients typically present with severe headaches, fatigue, polymyalgia-like symptoms, or ischemic complaints such as jaw claudication. Visual loss is the major feared irreversible outcome and can occur in up to 50% of those with untreated disease. Glucocorticoids, typically high dose prednisone (> or = 60 mg/d) is the first-line treatment and successfully controls the inflammatory disease in the vast majority of patients. Most patients can be tapered off steroids within 6 months to 2 years.
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PMID:Inflammatory disease in older adults. Cranial arteritis. 1566 19

Polymyalgia rheumatica is a rheumatic disease which mainly affects the elderly, and is seldom diagnosed in patients <50 years of age. The prevalence of polymyalgia rheumatica is approximately 16.8 to 53.7 per 100,000 of the population >50 years of age. Patients may present with spiking fever, malaise, fatigue, weight loss and other features suggesting inflammation, which in each case requires differential diagnosis from malignancies. Neoplastic disease in turn can manifest itself in symptoms resembling those of polymyalgia, which are named "polymyalgia-like syndrome" and are in fact paraneoplastic syndromes presenting as polymyalgia rheumatica. These observations suggest that a careful clinical evaluation and a long term follow-up are necessary for a correct diagnosis of polymyalgia rheumatica.
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PMID:[Polymyalgia rheumatica mimicking neoplastic disease--significant problem in elderly patients]. 1956 70