Document Detail


Polymyalgia rheumatica and giant cell arteritis.
MedLine Citation:
PMID:  17111894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Polymyalgia rheumatica and giant cell arteritis are common, closely related vasculitic conditions that almost exclusively occur in patients older than 50 years. They may be manifestations of the same underlying disease and often coexist. Patients with polymyalgia rheumatica usually present with acute onset of stiffness and pain in the shoulder and pelvic musculature, which may be accompanied by fever, malaise, and weight loss. If untreated, polymyalgia rheumatica may result in significant disability. Giant cell arteritis may manifest as visual loss or diplopia, abnormalities of the temporal artery such as tenderness or decreased pulsation, jaw claudication, and new-onset headaches. Erythrocyte sedimentation rate and temporal artery biopsy help make the diagnosis. Giant cell arteritis requires urgent diagnosis because without treatment it may lead to irreversible blindness. Patients with either condition also may have nonspecific symptoms. Corticosteroids are the mainstay of therapy for both conditions, with higher doses required for treatment of giant cell arteritis. Duration of corticosteroid therapy can be five years or longer before complete clinical remission is achieved. Monitoring for corticosteroid-associated side effects such as osteoporosis and diabetes, as well as for relapses and flare-ups, is key to chronic management. The prognosis for either condition, if treated, is good.
Authors:
Brian Unwin; Cynthia M Williams; William Gilliland
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American family physician     Volume:  74     ISSN:  0002-838X     ISO Abbreviation:  Am Fam Physician     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-20     Completed Date:  2006-12-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  1272646     Medline TA:  Am Fam Physician     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1547-54     Citation Subset:  AIM; IM    
Affiliation:
Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. bunwin@usuhs.mil
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MeSH Terms
Descriptor/Qualifier:
Aged
Diagnosis, Differential
Diagnostic Imaging
Giant Cell Arteritis / diagnosis*,  drug therapy*
Glucocorticoids / therapeutic use*
Humans
Middle Aged
Polymyalgia Rheumatica / diagnosis*,  drug therapy*
Prednisone / therapeutic use*
Prognosis
Chemical
Reg. No./Substance:
0/Glucocorticoids; 53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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