Home Polymyalgia Rheumatica (PR)

Polymyalgia Rheumatica (PR)

Defining Characteristics

Dx critieria:
Persistent proximal pain (>1m) involving (neck, shoulders, pelvic girdle- 2), >1h morning stiffness, abrupt onset of illness (50, Rapid response to low dose prednisone, elevated ESR, absence of other disorders (flu, hypothyroidism)

Disease Development

Polygenic (environment & genetics)
Activation of innate immune system leads to elevated levels of TNF

Potential Causes

Genetic component (HLA-DR)
Genetic polymorphisms in adhesion molecules & TNF


Extremely unlikely in pts 50 (less in Italians)

Risk factors

Can be associated w/ Giant cell arteritis


Elevated ESR/CRP Thrombocytosis (hi platelets) Nl CPK
Anemia of chronic dz
Negative ANA, RF
Clinical dx

Conventional Treatment

Corticosteroids (Should be RAPID
response if right dx)