Cantini Fabrizio, Niccoli Laura, Storri Lara, Nannini Carlotta, Olivieri Ignazio, Padula Angela, Boiardi Luigi, Salvarani Carlo
2nd Divisione de Medicina, Unità Reumatologica, Ospedale di Prato, Prato, Italy.
Semin Arthritis Rheum. 2004 Apr;33(5):294-301. doi: 10.1016/j.semarthrit.2003.09.008.
To summarize the evidence about the relationship between polymyalgia rheumatica (PMR) and giant cell arteritis (GCA).
Review of relevant articles from the English-language literature.
Epidemiologic studies suggest that PMR and GCA are closely related conditions affecting people over 50 years and frequently occurring in the same patient. PMR symptoms have been observed in 40 to 60 percent of GCA clinical series. Also, temporal artery biopsy may yield positive results for GCA in patients with isolated PMR. Conflicting HLA-DRB1 genotype results have been reported, and recent studies have shown that PMR and GCA have different expression of RANTES, TNFalpha microsatellite, and IL-6 promoter genetic polymorphisms. Search for a possible common infectious agent have yielded disappointing results. Although parvovirus B19 DNA is present in the artery wall of patients with GCA, this virus may be only an innocent bystander. Cytokine studies on a limited number of temporal artery biopsy specimens have shown that interferon-gamma is produced in GCA and not in PMR, suggesting that this cytokine may be crucial to the development of overt vasculitis.
PMR and GCA frequently occur together but no definitive conclusions can be drawn about the nature of this association.
总结有关风湿性多肌痛（PMR）与巨细胞动脉炎（GCA）之间关系的证据。
回顾英文文献中的相关文章。
流行病学研究表明，PMR和GCA是密切相关的疾病，影响50岁以上人群，且常发生于同一患者。在40%至60%的GCA临床病例系列中观察到了PMR症状。此外，颞动脉活检在孤立性PMR患者中可能得出GCA的阳性结果。关于HLA - DRB1基因型的结果存在矛盾，近期研究表明，PMR和GCA在RANTES、TNFα微卫星和IL - 6启动子基因多态性方面有不同表达。寻找可能的共同感染因子的结果令人失望。虽然细小病毒B19 DNA存在于GCA患者的动脉壁中，但该病毒可能只是一个无辜的旁观者。对有限数量的颞动脉活检标本进行的细胞因子研究表明，γ干扰素在GCA中产生而在PMR中不产生，这表明该细胞因子可能对明显血管炎的发生至关重要。
PMR和GCA经常同时出现，但关于这种关联的性质尚无定论。
