Clinical manifestations of polymyalgia rheumatica – a single centre experience

Marin Petrić, Daniela Marasović Krstulović, Mislav Radić, Katarina Borić, Ivona Božić, Dijana Perković

Introduction. Polymyalgia rheumatica (PMR) is a chronic inflammatory rheumatic disease that occurs mainly in patients over the age of 50. It is characterised by pain and stiffness in the shoulder and pelvic girdle and neck. Some patients develop giant cell arteritis (GCA). The aim of our study was to present clinical characteristics of PMR patients diagnosed in the period from January 2015 to July 2020 at the Division of Rheumatology and Clinical Immunology, Split University Hospital Centre, Croatia. Materials and methods. We analysed available medical records of patients diagnosed with PMR in accordance with the 2012 EULAR /ACR classification criteria. Methods of descriptive statistics were used in the analysis. Forty-nine PMR patients were included in the study. The mean age of patients was 77, and 67.35% of included patients were female. Results. The most frequent PMR manifestation was joint pain, which was documented in 91.84% patients, followed by fever in 28.57% cases. GCA was diagnosed in 6 cases (12.24%). The most common comorbidities were arterial hypertension (73.47%), followed by type 2 diabetes (38.78%). In 3 cases (6.12%) the malignant disease was diagnosed in the period of one year before and after the diagnosis of PMR. All patients received glucocorticoid therapy (GC) and remission was achieved in 45 (91.84%) cases. Conclusion. In conclusion, PMR is a disease which commonly affects the elderly, and it is successfully treated with GC. As expected, the most common symptom was joint pain, and the most common comorbidity was arterial hypertension. We did not find a higher prevalence of malignant diseases, so PMR should not be viewed as part of the paraneoplastic syndrome, which was also confirmed by the results of the recently conducted studies.

Uvod. Reumatska polimialgija (lat. polymialghia reumatica – PMR) je kronična upalna reumatska bolest koja se javlja uglavnom kod bolesnika starijih od 50 godina. Najčešće se prezentira bolovima i ukočenošću u području ramenog i zdjeličnog obruča te vrata. U pojedinih bolesnika dolazi do razvoja arteritisa divovskih stanica (engl. Giant Cell Arteritis – GCA). Cilj ovoga istraživanja jest prikazati kliničke karakteristike bolesnika kojima je dijagnosticirana PMR u razdoblju od početka 2015. godine do srpnja 2020. godine na Zavodu za reumatologiju i kliničku imunologiju Kliničkoga bolničkog centra (KBC -a) Split. Materijali i metode. U istraživanje su uključeni bolesnici kojima je dijagnosticirana PMR prema EULAR /ACR klasifikacijskim kriterijima iz 2012. godine. Podatci su prikupljeni pregledom dostupne medicinske dokumentacije. U analizi rezultata korištene su metode deskriptivne statistike. Ukupno je dijagnosticirano 49 bolesnika s PMR-om. Prosječna dob je 77 godina, a prevladavaju osobe ženskog spola (67,35%). Rezultati. PMR se najčešće manifestirala bolovima u zglobovima (u 91,84% bolesnika) te febrilitetom (u 28,57% bolesnika). U 6 bolesnika (12,24%) je naknadno dijagnosticiran GCA. Najčešći pridruženi komorbiditeti bili su arterijska hipertenzija (73,47%) i šećerna bolest tipa 2 (38,78%). U troje bolesnika (6,12%) maligna bolest je dijagnosticirana u periodu od jednu godinu prije i nakon postavljanja dijagnoze PMR-a. Liječenje glukokortikoidima (GC) provedeno je u svih bolesnika, a u njih 45 (91,84%) postignuta je remisija bolesti. Zaključak. Zaključno, PMR je bolest koja se javlja u starijoj životnoj dobi i uspješno se liječi GC. Najčešća klinička prezentacija u naših bolesnika bila je bol u zglobovima, dok je najčešći komorbiditet bila arterijska hipertenzija. Nije potvrđeno da je PMR paraneoplastična bolest, što se poklapa s podatcima dostupnim iz literature.