Němec Petr, Šprláková-Puková Andrea, Řehák Zdeněk
Vnitr Lek. 2018 Spring;64(2):173-183.
Polymyalgia rheumatica is the most frequent inflammatory disease of people over 50 years of age. It mainly affects the Caucasian race and roughly 2-3 times as many women. From the viewpoint of etiology, polymyalgia rheumatica is a complex disease. Involved in its origin is genetic predisposition, factors of age and outer environment. 16-21 % of patients with polymyalgia rheumatica may at the same time have symptoms of giant cell arteritis. Diagnosis is made primarily on the basis of clinical symptoms and it is supported by the presence of laboratory signs of inflammation. There is no specific diagnostic test available for diagnosing polymyalgia rheumatica. In recent time modern imaging devices, e.g. ultrasonography or positron emission tomography, can be used in diagnosing the disease. In the past a number of diagnostic and classification criteria were established which may be used in diagnosing of polymyalgia rheumatica in general practice. The differential diagnostics of the disease is extensive. Before the treatment commencement it is necessary to rule out the presence of another disease with manifestations simulating polymyalgia rheumatica. The treatment strategy should draw on the current EULAR/ACR Recommendations for the treatment of polymyalgia rheumatica issued in 2015.Key words: polymyalgia rheumatica - positron emission tomography - prognosis - treatment - ultrasonography.
风湿性多肌痛是50岁以上人群中最常见的炎性疾病。它主要影响白种人,女性患者约为男性的2至3倍。从病因学角度来看,风湿性多肌痛是一种复杂的疾病。其发病与遗传易感性、年龄因素及外部环境有关。16%至21%的风湿性多肌痛患者可能同时出现巨细胞动脉炎的症状。诊断主要基于临床症状,并由炎症的实验室指标支持。目前尚无用于诊断风湿性多肌痛的特异性诊断试验。近年来,现代成像设备,如超声检查或正电子发射断层扫描,可用于该疾病的诊断。过去已确立了许多诊断和分类标准,可用于在全科医疗中诊断风湿性多肌痛。该疾病的鉴别诊断范围广泛。在开始治疗前,有必要排除存在其他表现类似风湿性多肌痛的疾病。治疗策略应借鉴2015年发布的欧洲抗风湿病联盟/美国风湿病学会关于风湿性多肌痛治疗的现行建议。关键词:风湿性多肌痛 - 正电子发射断层扫描 - 预后 - 治疗 - 超声检查