Hayashi Koji, Maeda Hiroaki, Hayashi Hiromi, Suzuki Asuka, Nakaya Yuka, Sato Mamiko, Hayashi Kouji, Kobayashi Yasutaka
Department of Rehabilitation Medicine, Fukui General Hospital, Fukui, JPN.
Graduate School of Health Science, Fukui Health Science University, Fukui, JPN.
Cureus. 2024 Oct 2;16(10):e70671. doi: 10.7759/cureus.70671. eCollection 2024 Oct.
We describe a case of polymyalgia rheumatica (PMR) following an influenza B infection. The patient was a 71-year-old woman who developed a fever above 38.0°C and was diagnosed with influenza B, confirmed by a rapid antigen test. Although the fever resolved after three days, she continued to experience neck pain, back pain, and joint pain, particularly in both shoulders and hips. She also reported morning joint stiffness lasting for more than an hour and occasional low-grade fever. She presented to our hospital 25 days after the onset of symptoms. Blood tests revealed elevated C-reactive protein and erythrocyte sedimentation rate, but levels of creatine phosphokinase, rheumatoid factor, and anti-cyclic citrullinated peptide were not elevated. She was diagnosed with PMR and treated with prednisolone (PSL) 15 mg/day. The response to steroids was remarkably good, and PSL was tapered over six months. PMR is believed to result from an immune-mediated process and may be associated with certain human leukocyte antigen haplotypes. Additionally, PMR is sometimes preceded by an infection. To date, there have been very few reports suggesting a connection between influenza B and PMR, underscoring the need for further case accumulation.
我们描述了一例乙型流感感染后发生的风湿性多肌痛(PMR)病例。患者为一名71岁女性,体温升至38.0°C以上,经快速抗原检测确诊为乙型流感。尽管发热在三天后消退,但她仍持续感到颈部疼痛、背部疼痛和关节疼痛,尤其是双肩和臀部。她还报告称早晨关节僵硬持续超过一小时,偶尔有低热。症状出现25天后她前来我院就诊。血液检查显示C反应蛋白和红细胞沉降率升高,但肌酸磷酸激酶、类风湿因子和抗环瓜氨酸肽水平未升高。她被诊断为PMR,并接受泼尼松龙(PSL)15毫克/天的治疗。对类固醇的反应非常良好,PSL在六个月内逐渐减量。PMR被认为是由免疫介导的过程引起的,可能与某些人类白细胞抗原单倍型有关。此外,PMR有时在感染之前出现。迄今为止,很少有报告表明乙型流感与PMR之间存在关联,这凸显了进一步积累病例的必要性。