Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Polymyalgia rheumatica (PMR) and temporal arteritis (TA) have been associated with a seronegative polyarthritis that can mimic rheumatoid arthritis. Sacroiliitis and osteitis pubis are most often encountered in the different types of spondyloarthropathy. However, sacroiliitis and osteitis pubis have rarely been described in patients with polymyalgia rheumatica and temporal arteritis. We present two patients, one with temporal arteritis and the other with polymyalgia rheumatica, who also had many features of a spondyloarthropathy, including sacroiliitis and osteitis pubis. In reviewing the literature, we found 30 other patients with a diagnosis of PMR who also had sacroiliitis and/or osteitis pubis. We propose that the inflammatory arthritis associated with polymyalgia rheumatica and temporal arteritis can involve the axial joints, resembling a spondyloarthropathy. It is important for the clinician to recognize that sacroiliitis and osteitis pubis have been associated with PMR and TA so that their radiographic presence does not dissuade the clinician from making the correct diagnosis.
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PMID:Polymyalgia rheumatica and temporal arteritis with sacroiliitis and osteitis pubis. 1703 46

Polymyalgia rheumatica (PMR) typically manifests as inflammatory pain in the shoulder and/or pelvic girdles in a patient over 50 years of age. This condition was long underrecognized and therefore underdiagnosed. Today, however, overdiagnosis may occur. Physicians must be aware that many conditions may simulate PMR, including diseases that carry a grim prognosis or require urgent treatment. PMR may be the first manifestation of giant cell arteritis, and a painstaking search for other signs is mandatory. PMR may inaugurate other rheumatologic diseases such as rheumatoid arthritis, RS3PE syndrome, spondyloarthropathy, systemic lupus erythematosus (SLE), myopathy, vasculitis, and chondrocalcinosis. Finally, PMR may be the first manifestation of an endocrine disorder, a malignancy, or an infection. Failure to respond to glucocorticoid therapy should suggest giant cell arteritis, malignant disease, or infection. Ultrasonography may assist in the diagnosis by showing bilateral subdeltoid bursitis. Glucocorticoids are the mainstay of the treatment of PMR. Although the optimal starting dosage and tapering schedule are not agreed on, a low starting dosage and slow tapering may decrease the relapse rate. Methotrexate is probably useful when glucocorticoid dependency develops. In contrast, TNF-alpha antagonists are probably ineffective.
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PMID:Polymyalgia rheumatica: diagnosis and treatment. 1711 8

Polymyalgia rheumatica (PMR) is a common inflammatory condition that often affects people over the age of 50 years. Characteristic symptoms are shoulder and hip girdle pain and prolonged morning stiffness. Markers of inflammation are often elevated. Clinicians are often faced with the challenge of distinguishing PMR from other conditions, particularly rheumatoid arthritis and spondyloarthropathy that can mimic symptoms of PMR in older people. Additionally, there is an association between PMR and giant cell arteritis, a common large-vessel vasculitis which also affects people over the age of 50 years. Imaging of the large vessels in asymptomatic patients with PMR often reveals findings of subclinical vasculitis. Presently, there are no tests that are specific for the diagnosis of PMR and clinicians rely on a combination of history, physical examination, laboratory tests and imaging studies to make a diagnosis. A recent undertaking by the European League Against Rheumatism/American College of Rheumatology has led to the publication of provisional classification criteria of PMR. Ultrasonography, which is being increasingly used by rheumatologists, can greatly aid in the diagnosis of PMR and often shows changes of synovitis and tenosynovitis. Treatment consists of low doses of glucocorticoids which are associated with morbidity. Evaluation of newer biologic therapies targeting inflammatory cytokines is underway. Despite treatment, relapses are common.
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PMID:Advances and challenges in the diagnosis and treatment of polymyalgia rheumatica. 2448 11