Abstract:
We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck, shoulders, and pelvic girdle that lasted for 45 minutes each morning upon waking. Due to clinical suspicion of polymyalgia rheumatica (PMR), the patient was started on the standard therapy of low-dose glucocorticoid therapy and was noted to have a dramatic improvement in terms of pain, strength, mobility, and range of motion. Current literature shows high variability in the standard response time to treatment. Typical resolution of symptoms occurs within a span of one day to months. The case presented in our study shows symptom resolution as well as marked improvement in muscle strength and mobility within 12 hours. The purpose of this case report is to provide additional information for physicians when considering symptom-resolution time related to low-dose glucocorticoid therapy and PMR. Additionally, we briefly explore the literature on the correlation between giant cell arteritis (GCA) and glucocorticoid therapy for PMR as well as the data associated with adjuvant therapy using immunomodulatory treatment.
摘要:
我们介绍了一个75岁的白人女性的独特病例,她有两个月的持续近端肌肉疼痛和颈部僵硬的病史,肩膀,每天早上醒来时持续45分钟的骨盆带。由于临床怀疑风湿性多肌痛(PMR),患者开始接受低剂量糖皮质激素治疗的标准治疗,并注意到疼痛有显著改善,力量,移动性,和运动范围。目前的文献显示了对治疗的标准响应时间的高度可变性。症状的典型解决发生在一天到几个月的范围内。我们研究中提出的病例显示症状缓解以及12小时内肌肉力量和活动能力的显着改善。本病例报告的目的是在考虑与低剂量糖皮质激素治疗和PMR相关的症状解决时间时,为医生提供更多信息。此外,我们简要探讨巨细胞动脉炎(GCA)与糖皮质激素治疗PMR的相关性的文献,以及与使用免疫调节治疗的辅助治疗相关的数据.