Abstract
Clinical features of 7 patients with polymyalgia rheumatica (PMR) were described. The diagnosis of PMR was made according to the Bird's criteria. The mean age at the onset of the disease was 65 years old ranging from 50 to 73 years old and male-female ratio was 2 to 5. Myalgia was seen in upper arms, shoulder girdles and pelvic girdles frequently. Although patients with temporal arteritis was not present, two patients with polymyalgia arteritica with intermittent claudication, bruits over femoral artery and stenosis of femoral artery were present. The average ESR was 113mm/h (range, 91 to 183mm/h) and CRP was positive in all patients. Serum level of muscle enzymes and electromyogram were within normal limits in all patients. Anemia was found in most of the patients. Circulating immune complexes (CIC) were positive before the start of steroidal therapy in three of five examined. However, in the inactive stage of disease after steroidal therapy CIC in three patients became negative. This data suggests that immunological mechanism may be important in the pathogenesis of PMR. Prompt and dramatic response to prednisolone were seen in all patients, but it was not always easy to taper off dose of prednisolone and discontinue steroidal therapy. During follow-up, one patient died of acute heart failure and rheumatoid arthritis developed in one patient and sicca-like syndrome developed in other one patient. It was emphasized through this study that PMR will become one of the most popular rheumatic disease in older ages in Japan in near future.
