Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland;
Int J Gen Med. 2012;5:711-4. doi: 10.2147/IJGM.S35536. Epub 2012 Aug 22.
The case of a married couple developing polymyalgia rheumatica (PMR) consecutively is presented. The 55-year-old wife complained in June 2010 about pain in her neck. Case history, physical examination, and erythrocyte sedimentation rate (ESR) of 80 mm/hour led to the diagnosis of PMR. In May 2011, her 66-year old husband complained about pain in his neck, shoulders, buttocks, and thighs. Considering anamnesis, physical examination, and ESR of 56 mm/hour, the diagnosis of PMR was made. Both wife and husband responded to steroid treatment. When the steroid dose was gradually reduced, both patients relapsed. In order to lower the cumulative dose of glucocorticoid therapy, 10 mg methotrexate per week was added. In the literature, six cases of polymyalgia rheumatica in married couples have been described to date. In four cases, polymyalgia rheumatica occurred first in the wife. The interval of the diagnosis between the spouses ranged from 0 to 89 months. Although in most of the previous case reports a genetic disposition and an infectious agent have been discussed, this hypothesis must be questioned.
本文介绍了一对连续发生巨细胞动脉炎(PMR)的夫妇。55 岁的妻子于 2010 年 6 月抱怨颈部疼痛。根据病史、体格检查和 80mm/h 的红细胞沉降率(ESR),诊断为 PMR。2011 年 5 月,66 岁的丈夫抱怨颈部、肩部、臀部和大腿疼痛。考虑到病史、体格检查和 56mm/h 的 ESR,诊断为 PMR。夫妻双方均对类固醇治疗有反应。当逐渐减少类固醇剂量时,两人均复发。为了降低糖皮质激素治疗的累积剂量,每周加用 10mg 甲氨蝶呤。迄今为止,文献中已经描述了 6 对患有巨细胞动脉炎的夫妇。在 4 例中,巨细胞动脉炎首先发生在妻子身上。配偶之间的诊断间隔从 0 到 89 个月不等。尽管在大多数先前的病例报告中讨论了遗传倾向和感染因子,但这一假设必须受到质疑。