Polymyalgia rheumatica and giant-cell arteritis. 2008

Carlo Salvarani, and Fabrizio Cantini, and Gene G Hunder
Unit of Rheumatology, Arcispedale S Maria Nuova, Reggio Emilia, Italy. salvarani.carlo@asmn.re.it

Polymyalgia rheumatica and giant-cell arteritis are closely related disorders that affect people of middle age and older. They frequently occur together. Both are syndromes of unknown cause, but genetic and environmental factors might have a role in their pathogenesis. The symptoms of polymyalgia rheumatica seem to be related to synovitis of proximal joints and extra-articular synovial structures. Giant-cell arteritis primarily affects the aorta and its extracranial branches. The clinical findings in giant-cell arteritis are broad, but commonly include visual loss, headache, scalp tenderness, jaw claudication, cerebrovascular accidents, aortic arch syndrome, thoracic aorta aneurysm, and dissection. Glucocorticosteroids are the cornerstone of treatment of both polymyalgia rheumatica and giant-cell arteritis. Some patients have a chronic course and might need glucocorticosteroids for several years. Adverse events of glucocorticosteroids affect more than 50% of patients. Trials of steroid-sparing drugs have yielded conflicting results. A greater understanding of the molecular mechanisms involved in the pathogenesis should provide new targets for therapy.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011111 Polymyalgia Rheumatica A syndrome in the elderly characterized by proximal joint and muscle pain, high erythrocyte sedimentation rate, and a self-limiting course. Pain is usually accompanied by evidence of an inflammatory reaction. Women are affected twice as commonly as men and Caucasians more frequently than other groups. The condition is frequently associated with GIANT CELL ARTERITIS and some theories pose the possibility that the two diseases arise from a single etiology or even that they are the same entity. Forestier-Certonciny Syndrome,Pseudopolyarthritis, Rhizomelic,Rheumatism, Peri-Extra-Articular,Forestier Certonciny Syndrome,Peri-Extra-Articular Rheumatism,Pseudopolyarthritides, Rhizomelic,Rheumatism, Peri Extra Articular,Rhizomelic Pseudopolyarthritides,Rhizomelic Pseudopolyarthritis,Syndrome, Forestier-Certonciny
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D005260 Female Females
D005938 Glucocorticoids A group of CORTICOSTEROIDS that affect carbohydrate metabolism (GLUCONEOGENESIS, liver glycogen deposition, elevation of BLOOD SUGAR), inhibit ADRENOCORTICOTROPIC HORMONE secretion, and possess pronounced anti-inflammatory activity. They also play a role in fat and protein metabolism, maintenance of arterial blood pressure, alteration of the connective tissue response to injury, reduction in the number of circulating lymphocytes, and functioning of the central nervous system. Glucocorticoid,Glucocorticoid Effect,Glucorticoid Effects,Effect, Glucocorticoid,Effects, Glucorticoid
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D013700 Giant Cell Arteritis A systemic autoimmune disorder that typically affects medium and large ARTERIES, usually leading to occlusive granulomatous vasculitis with transmural infiltrate containing multinucleated GIANT CELLS. The TEMPORAL ARTERY is commonly involved. This disorder appears primarily in people over the age of 50. Symptoms include FEVER; FATIGUE; HEADACHE; visual impairment; pain in the jaw and tongue; and aggravation of pain by cold temperatures. (From Adams et al., Principles of Neurology, 6th ed) Aortic Arteritis, Giant Cell,Aortitis, Giant Cell,Arteritis, Temporal,Cranial Arteritis,Horton Disease,Horton Giant Cell Arteritis,Juvenile Temporal Arteritis,Temporal Arteritis,Arteritis, Giant Cell, Horton,Arteritis, Giant Cell, Horton's,Giant Cell Aortic Arteritis,Giant Cell Aortitis,Giant Cell Aortitis, Horton's,Giant Cell Arteritis, Horton,Horton's Disease,Horton's Giant Cell Arteritis,Aortitides, Giant Cell,Arteritides, Cranial,Arteritides, Giant Cell,Arteritides, Juvenile Temporal,Arteritides, Temporal,Arteritis, Cranial,Arteritis, Giant Cell,Arteritis, Juvenile Temporal,Cranial Arteritides,Giant Cell Aortitides,Giant Cell Arteritides,Hortons Disease,Juvenile Temporal Arteritides,Temporal Arteritides,Temporal Arteritides, Juvenile,Temporal Arteritis, Juvenile
D015994 Incidence The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases in the population at a given time. Attack Rate,Cumulative Incidence,Incidence Proportion,Incidence Rate,Person-time Rate,Secondary Attack Rate,Attack Rate, Secondary,Attack Rates,Cumulative Incidences,Incidence Proportions,Incidence Rates,Incidence, Cumulative,Incidences,Person time Rate,Person-time Rates,Proportion, Incidence,Rate, Attack,Rate, Incidence,Rate, Person-time,Rate, Secondary Attack,Secondary Attack Rates

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