1/52. Secondary (AA-type) amyloidosis in patients with polymyalgia rheumatica.Several cases of systemic amyloidosis associated with polymyalgia rheumatica (PMR) or giant-cell arteritis (GCA) have been described. Nevertheless, the type of amyloid deposit has not been characterized in most of them. Here we report on two patients with PMR (one with associated GCA) who developed nephrotic syndrome and end-stage renal failure caused by massive amyloid deposition. Immunohistochemical analysis showed that the amyloid deposits were of AA type (secondary amyloidosis) in both cases.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/52. polymyalgia rheumatica and temporal arteritis: a case presentation.polymyalgia rheumatica (PMA) and temporal arteritis (TA) are common clinical syndromes that affect the elderly population. Both syndromes may include similar constitutional complaints, an increase in acute phase reactants, a rapid response to corticosteroids, and the presence of anteritis giant cells upon temporal artery biopsy. Differential diagnosis is one of exclusion. A case presentation is included to assist practitioners in recognizing presenting symptoms, identifying diagnostic testing, and proceeding with appropriate therapy and follow-up.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/52. polymyalgia rheumatica as a manifestation of a large hepatic cavernous hemangioma.A 59-year-old woman presented with polymyalgia rheumatica which was refractory to conventional anti-inflammatory and steroid therapy. A full investigation for an underlying occult malignancy showed only the presence of a giant cavernous hepatic hemangioma. To our knowledge, polymyalgia rheumatica has never been described in association with giant cavernous hepatic hemangioma; resection of the latter lesion resulted in complete and, to this date, definite resolution of rheumatologic complaints in our patient.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
4/52. polyarteritis nodosa mimicking polymyalgia rheumatica.We report a case of polyarteritis nodosa with a clinical presentation mimicking polymyalgia rheumatica, as well as pathological findings of non-giant-cell arteritis on temporal artery biopsy with symptoms of jaw claudication. Although certain clinical syndromes have been attributed to specific types of systemic vasculitis, considerable overlap occurs. Obtaining tissue biopsy in cases of vasculitis is mandatory for diagnosis and classification.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/52. Assessment and management of polymyalgia rheumatica in older adults.polymyalgia rheumatica (PMR) is a periarticular rheumatic condition characterized by pain and stiffness, primarily in the neck, shoulders, hips, and pelvic girdle. Temporal arteritis (TA) or giant cell arteritis, the most common primary vasculitis in older adults, is found in approximately 10% to 30% of people who have PMR. Left untreated, TA can result in sudden, irreversible blindness. Geriatric nurses need to familiarize themselves with these disorders to accurately assess and manage people with them.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/52. polymyalgia rheumatica and giant cell arteritis. Avoiding management traps.BACKGROUND: polymyalgia rheumatica (PMR) needs to be considered in the patient over 55 years of age who presents with stiffness and pain. It appears to exist in a continuum with giant cell arteritis (GCA), and the differential diagnosis is large. It may affect one in 200 patients in this age group. Corticosteroid toxicity is a major problem, either because of inappropriate dosage or prolonged disease. OBJECTIVE: To provide an up to date understanding of the concepts of this group of disorders in order to allow rapid recognition, better management, and to minimise toxicity of the necessary treatment. The most important of these are the appropriate dose of corticosteroid and instituting preventive therapy for potential complications such as osteoporosis. DISCUSSION: As there is no specific test for PMR, the diagnosis is still made on clinical grounds from the presentation, symptoms and signs, and the presence of serological markers of inflammation. Because these are all nonspecific, alternative diagnoses must be actively excluded. Certain newer investigations, such as high resolution ultrasound of the temporal arteries may be very helpful in directing temporal artery (TA) biopsies. When the response to treatment does not follow the usual course (and this may be prolonged: 18 months to five years or more), then re-evaluation is imperative.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/52. giant cell arteritis and renal amyloidosis: report of a case.polymyalgia rheumatica and giant cell arteritis are rarely associated with renal diseases such as amyloidosis. Here is a case of a 72-year-old man, who developed some renal failure and a nephrotic syndrome while presenting clinical symptoms of giant cell arteritis. Percutaneous renal biopsy showed secondary amyloidosis, and temporal artery biopsy revealed some lesions which suggested temporal arteritis. In spite of aggressive steroid treatment, chlorambucil, and colchicine, the patient's renal function continued to deteriorate and the patient is now being given hemodyalisis.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
8/52. Familial giant cell arteritis and polymyalgia rheumatica: aggregation in 2 families.The ethnic and geographic prevalence, the familial aggregation, and the reported association with some HLA class II antigens of both giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) strongly suggest the role of genetic factors in the pathogenesis of these diseases. We describe the familial aggregation of GCA and PMR in 2 unrelated families from Northern italy. In the first family, 2 sisters developed GCA a few months apart. In the second, one sister had GCA, and 2 years later her siblings developed PMR nearly simultaneously. patients with GCA in the first family shared the whole HLA genotype (A*24,*26, B*38,*55, DRB1*11,*14, DQB1*05,*07, DRB3*). In the second family, both PMR siblings carried the A*68, B*44, DRB1*11, DQB1*07, DRB3* alleles. Thus all patients of both families shared DRB1*11, DQB1*07, and DRB3*. Predisposing immunogenetic factors of both GCA and PMR are discussed.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
9/52. Myelodysplastic and myeloproliferative syndromes associated with giant cell arteritis and polymyalgia rheumatica: a coincidental coexistence or a causal relationship?A variety of systemic autoimmune disorders have been reported in patients with myelodysplastic and myeloproliferative syndromes. A possible association with polymyalgia rheumatica and giant cell arteritis has also been recognised. We report another case of polymyalgia rheumatica and one of giant cell arteritis associated with a myelodysplastic syndrome and the two first cases of giant cell arteritis associated with essential thrombocytaemia and chronic myelomonocytic leukaemia, respectively. It seems that there is a relationship between these entities, but the nature of this association is still unknown.- - - - - - - - - - ranking = 7keywords = giant (Clic here for more details about this article) |
10/52. polymyalgia rheumatica.polymyalgia rheumatica should be considered when a syndrome of constitutional symptoms, especially weight loss, low-grade fever, weakness, wasting proximal muscles, fatigue, malaise and depression, is seen in the elderly. Giant-cell arteritis plays a part later in the course. Thus the need for biopsy of a long segment of the temporal artery to help in determining diagnosis and therapy. An elevated erythrocyte sedimentation rate (ESR) is an important clue. The usual high value is about 80 mm/hour; if it is over 100 mm/hour, giant-cell arteritis should be suspected. salicylates, indomethacin, phenylbutazone and hydroxychloroquine produce some clinical improvement but do not lower the high ESR; moreover, the patients are prone to experience relapses. prednisone, however, not only produces clinical improvement but lowers the high ESR. potassium p-aminobenzoate may be useful in maintaining the remission.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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