Toro-Gutiérrez Carlos Enrique, Cañas Carlos A, Mantilla Rubén D, Beltrán Santiago, Pastrana-Gonzalez Vivian, Vecino Milly J, Rodriguez-Jimenez Mónica, Rojas Manuel
Centro de Referencia en Osteoporosis, Reumatología & Dermatología, Cali, Colombia.
Rheumatology Unit, Fundación Valle Del Lili, Cali, Colombia.
J Transl Autoimmun. 2021 Aug 21;4:100115. doi: 10.1016/j.jtauto.2021.100115. eCollection 2021.
Polymyalgia rheumatica (PMR) is the most common inflammatory disease in patients over 50 years. Information about the disease in Latin America (LATAM) is scarce. We aimed to evaluate a group of Colombian patients with PMR and to conduct a systematic review of PMR in LATAM.
A multicentric retrospective study was performed. Medical records of 256 PMR patients were evaluated. Patients were divided into two groups, those fulfilling the 2012 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) classification criteria for PMR and those who did not (i.e., clinical diagnosis). A systematic literature review and meta regression was performed comparing Colombian vs LATAM patients.
From 256 patients, 145 (56.6%) fulfilled the 2012 EULAR/ACR criteria, and 111 (43.3%) were classified by clinical diagnosis. Inflammatory bilateral shoulder pain, pelvic girdle aching, morning stiffness >45 min, elevated erythrocyte sedimentation rate (ESR), and C-reactive protein (CPR), and Methotrexate (MTX) prescription were more common in the 2012 EULAR/ACR group. None of the included patients presented overt polyautoimmunity (PolyA), whereas up to 24% exhibited latent PolyA. In addition, these patients showed high frequency of malignancy (7.59%). In the meta regression analysis, Colombian patients exhibited lower ESR levels, and were less likely to develop giant cell arteritis (GCA) as compared to the rest of LATAM data.
Patients with PMR in LATAM exhibit similar phenotypes from other cohorts worldwide. Malignancy, GCA and latent PolyA should be considered in the routine clinical follow-up of patients with PMR.
风湿性多肌痛（PMR）是50岁以上患者中最常见的炎性疾病。拉丁美洲（LATAM）关于该疾病的信息稀缺。我们旨在评估一组哥伦比亚PMR患者，并对拉丁美洲的PMR进行系统评价。
进行了一项多中心回顾性研究。评估了256例PMR患者的病历。患者被分为两组，一组符合2012年欧洲抗风湿病联盟/美国风湿病学会（EULAR/ACR）PMR分类标准，另一组不符合（即临床诊断）。进行了系统的文献回顾和meta回归分析，比较了哥伦比亚患者与拉丁美洲患者。
256例患者中，145例（56.6%）符合2012年EULAR/ACR标准，111例（43.3%）通过临床诊断分类。双侧肩部炎性疼痛、骨盆带疼痛、晨僵>45分钟、红细胞沉降率（ESR）升高、C反应蛋白（CPR）升高以及甲氨蝶呤（MTX）处方在2012年EULAR/ACR组中更为常见。纳入的患者均未出现明显的多自身免疫性（PolyA），而高达24%的患者表现为潜伏性PolyA。此外，这些患者恶性肿瘤发生率较高（7.59%）。在meta回归分析中，与拉丁美洲其他数据相比，哥伦比亚患者的ESR水平较低，发生巨细胞动脉炎（GCA）的可能性较小。
拉丁美洲的PMR患者表现出与全球其他队列相似的表型。在PMR患者的常规临床随访中应考虑恶性肿瘤、GCA和潜伏性PolyA。
