Abstract
Objective: The objective of this study was to clarify the characterizations of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome.
Methods: Seven patients with PMR and 12 patients with RS3PE were compared in terms of the type of onset, the complication rate of carpal tunnel syndrome (CTS), the initial usage of doses of prednisolone (PSL), the tendency of recurrence, and laboratory examination results. The latter included a blood examination and C-reactive protein (CRP), rheumatoid factor (RF), and anti-cyclic citrullinated peptide (CCP) antibody titers. Statistical analysis was done by chi-squared or Mann-Whitney tests. Results: The acute onset ratios for the PMR and RS3PE groups were 28.5% (2/7) and 75% (9/12), respectively (p=0.01). The complication rates of CTS were 4/7 (57.1%) and 6/12 (50%) and the serum concentrations of CRP (mg/dl) were 5.8 and 6.04 in the PMR and RS3PE groups, respectively. The recurrence rate was 6/7 (88%) in the PMR group and 4/12 (33%) in the RS3PE group (p=0.03). In this article, a case of PMR with concomitant CTS was presented as a sign of recurrence. We report the singular behavior of CTS in a female patient with PMR during treatment of PMR with PSL. At first the patients CTS condition was not noticed, but it became evident after treatment with PSL was initiated and even became exacerbated when the PMR condition had subsided and PSL treatment terminated. The CTS condition was relieved by surgically releasing the median nerve from compression and by resuming administration of PSL.
Conclusions: It was observed that patients with PMR were more likely to experience chronic onset and recurrence compared with those with RS3PE syndrome. Both diseases were likely to be complicated with CTS.
