リウマチ性多発筋痛症の13例とくにその診断およびHLA抗原について

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Polymyalgia rheumatica (PMR) is a clinical entity characteristic with pains and morning stiffness of neck-shoulder-gurdle muscles. Although the prevalence of PMR has been thought to be very low in Japan to date, we experienced 13 patients these three years. There is necessity for us to clarify the characteristics of Japanese patients with PMR. These 13 patients were primarily diagnosed based on the criteria from Bird et al. and from Healey, and compared their clinical features and laboratory findings with rheumatoid arthritis (RA) and with polymyositis/dermatomyositis (PM/DM). We now propose preliminary diagnostic criteria for PMR as follow: 1) Older than 50 years old. 2) Remarkable muscle stiffness in the morning on neck, shoulders and/or gurdles. 3) Tenderness of proximal muscles without muscle atrophy or the elevation of myogenic enzymes. 4) Sudden onset. 5) Fever at onset. 6) No swellings, pains nor stiffness of hands, feet and fingers. 7) Corrected ESR more than 70 mm/hr or CRP titer higher than 3 positives. 8) Negative rheumatoid factor, antinuclear antibodies nor other autoantibodies. 9) More than 0.8 g/dl of serum α2 globulin and/or more than 40 of CH50. Definite diagnosis of PMR can be made with more than 7 fullfill ed criteria. PM/DM, RA, osteoarthropathy, cervical syndrome and adult-onset Still's disease should be excluded.Significant increases of HLA-A11, A26 and Cw3 were demonstrated in the patients with PMR comparing with those in healthy Japanese population, however no association with HLA-DR nor DQ system was proved.
日本臨床免疫学会の論文

リウマチ性多発筋痛症の13例とくにその診断およびHLA抗原について

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リウマチ性多発筋痛症の13例 とくにその診断およびHLA抗原について

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リウマチ性多発筋痛症の13例とくにその診断およびHLA抗原について