Polymyalgia rheumatica in 2011

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• 作者：Alessandra Soriano ; MD^a ; Raffaele Landolfi ; MD^b ; Raffaele Manna ; MD^a ; ^b ; ^{rmanna@rm.unicatt.it}
• 关键词：Polymyalgia rheumatica ; Epidemiology ; Diagnostic criteria ; Aetiopathogenesis ; Clinical Manifestations ; Laboratory ; Imaging ; Treatment ; Relapse
• 刊名：Best Practice Research Clinical Rheumatology
• 出版年：2012
• 出版时间：February, 2012
• 年：2012
• 卷：26
• 期：1
• 页码：91-104
• 全文大小：268 K

文摘

Polymyalgia Rheumatica (PMR) is an inflammatory rheumatic disease that commonly affects individuals over 50 years of age, characterised by pain and morning stiffness of the shoulder and pelvic girdle. PMR can present as ¡®isolated?form or may be associated with giant cell arteritis. The progress of imaging techniques has helped in understanding different clinical patterns: subclinical vasculitis can occur in at least one-third of PMR patients, causing ischaemic complications. It is considered a polygenic disease and environmental factors may play a role in its pathogenesis, such as viral or bacterial triggers, both in the ¡®wide?form or assembled with adjuvants in vaccines. The response to steroid therapy is generally dramatic and side effects may occur, as well as the development of glucocorticoid resistance. The optimisation of therapy may require steroid-sparing agents as well as modified-release prednisone as ¡®nighttime?replacement therapy.