a Rheumatology Unit, Department of Internal Medicine , Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico , Reggio Emilia , Italy.
Expert Rev Clin Immunol. 2016 Oct;12(10):1037-45. doi: 10.1080/1744666X.2016.1178572. Epub 2016 May 6.
Polymyalgia rheumatica is one of the most common rheumatic inflammatory disorders in people older than 50 years characterized by aching and prolonged morning stiffness in the shoulder and pelvic girdle and neck..
In this review, we will focus on recent advances on the diagnosis and management of PMR. Expert commentary: Controversy exist whether PMR represent a single entity disease or is an umbrella term that comprises a clinical presentation common to a range of related conditions (polymyalgic syndrome). To date there are no specific diagnostic tests, and the diagnosis remains clinical, although ultrasonography, positron emission tomography scan and the recent ACR/EULAR classification criteria may help to confirm the clinical diagnosis. A step-wise process for the diagnosis of PMR has been proposed. Low-dose steroids are highly effective in the majority of patients and remain the mainstay of treatment, but relapses occur in about 50% of patients and glucocorticoid related adverse event are common. The steroid sparing effects of the immunosuppressive treatment evaluated to date are unclear.
巨细胞动脉炎是 50 岁以上人群中最常见的风湿性炎症性疾病之一，其特征是肩部、骨盆带和颈部疼痛和长时间晨僵。
在这篇综述中，我们将重点介绍 PMR 的诊断和治疗的最新进展。
目前存在争议的是，PMR 是否代表单一实体疾病，还是一个包含一系列相关疾病（巨细胞性多肌痛）共同表现的总称。迄今为止，尚无特定的诊断测试，诊断仍然是临床诊断，尽管超声、正电子发射断层扫描和最近的 ACR/EULAR 分类标准可能有助于确认临床诊断。已经提出了 PMR 的诊断步骤。大多数患者的低剂量类固醇治疗非常有效，仍然是主要的治疗方法，但约 50%的患者会复发，糖皮质激素相关的不良反应很常见。迄今为止，评估的免疫抑制治疗的类固醇节约效果尚不清楚。
