Three Cases of Polymyalgia Rheumatica (PMR)

概要

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Polymyalgia rheumatica (PMR) has been a rare rheumatic disease in Japan, although it is common in European and American Caucation. But since the first report, PMR is one of well established rheumatic diseases. We report three cases consisting of 46-year-old male, 76-year-old female and 36-year-old female with PMR in our hospital for two years. All of them presented with clinical manifestations of myalgia involving mainly proximal areas of trunks, gait disturbance, and fever of unknown origin refractory to antibiotics. None of them showed abnormalities on physical and roentgenological examinations, EMG, and brain angiography. Laboratory data were summarized as follows; normocytic anemia, remarkably increased erythrocyte sedimentation rate, strongly positive CRP, and negative PPD skin tests. Autoantibodies including anti-DNA antibody, anti-ENA antibody, ANF, LE cell and rheumatoid factors were all negative. Cryoglobulin was positive in one of them, which is seldom reported in the literature. The possibility of association with temporal arteritis was excluded on the basis of clinical signs and symptoms, or angiography.As to the therapy, all of them responded well to corticosteroid (prednisolone) with prompt disappearance of myalgia and fever, normalized erythrocyte sedimentation rate, and made favorable progress in a maintenance dose of 5 mg daily.
日本臨床免疫学会の論文