Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica

Hidekatsu Yanai1,2, Hiroshi Yoshida2,3, Norio Tada1,21Division of General Medicine, Department of Internal Medicine, The Jikei University School of Medicine, Kashiwa, Japan; 2Institute of Clinical Medicine and Research, The Jikei University School of Medicine, Chiba, Japan; 3Department of Laboratory...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Hidekatsu Yanai, Hiroshi Yoshida, Norio Tada
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2009
Materias:
Acceso en línea:https://doaj.org/article/ae108a9796da49b6966420de523dfbfc
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:ae108a9796da49b6966420de523dfbfc
record_format dspace
spelling oai:doaj.org-article:ae108a9796da49b6966420de523dfbfc2021-12-02T04:32:23ZClinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica1178-1998https://doaj.org/article/ae108a9796da49b6966420de523dfbfc2009-10-01T00:00:00Zhttps://www.dovepress.com/clinical-radiological-and-biochemical-characteristics-in-patients-with-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Hidekatsu Yanai1,2, Hiroshi Yoshida2,3, Norio Tada1,21Division of General Medicine, Department of Internal Medicine, The Jikei University School of Medicine, Kashiwa, Japan; 2Institute of Clinical Medicine and Research, The Jikei University School of Medicine, Chiba, Japan; 3Department of Laboratory Medicine, The Jikei University School of Medicine, Kashiwa, JapanAbstract: To find out clues to differentiate between polymyalgia rheumatica (PMR) and other diseases that mimic PMR. We studied Japanese patients with PMR (n = 7), pseudogout (n = 1), remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome (n = 1), and post-infectious polyarthritis (n = 1). The distribution of inflammation in patients was evaluated using a gallium-67 scintigraphy. We measured serum C-reactive protein (CRP), matrix metalloproteinase- 3 (MMP-3), and vascular endothelial growth factor (VEGF) in patients before and after treatment. Further, we compared the clinical course of PMR with that of other diseases that mimic PMR. Patients with pseudogout, RS3PE syndrome, post-infectious polyarthritis manifested similar changes in scintigraphic findings and serum CRP, MMP-3, and VEGF levels to PMR before the treatment. A significant reduction in serum CRP levels at one week after use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a good clue to differentiate pseudogout and post-infectious polyarthritis from PMR. Chondrocalcinosis in the radiographs of joints is also effective to differentiate pseudogout from PMR. A small reduction of CRP levels after NSAIDs use and promptly ameliorated CRP and symptoms by a low-dose steroid therapy, which was commonly observed in patients with PMR, were also found in a patient with RS3PE syndrome. Pitting edema of the back of hands and gallium uptake in metacarpophalangeal (MCP) joints were useful to differentiate RS3PE syndrome from PMR. In conclusion, pseudogout, RS3PE syndrome, post-infectious polyarthritis should be included in the spectrum of diseases mimicking PMR. A promptly decreased serum CRP level by NSAIDs is a good clue to differentiate pseudogout and post-infectious polyarthritis from PMR. Pitting edema of the back of hands and symmetric gallium uptake in MCP joints are characteristic for RS3PE syndrome.Keywords: gallium-67 scintigraphy, polymyalgia rheumatica, pseudogout, post-infectious polyarthritis, RS3PE syndromeHidekatsu YanaiHiroshi YoshidaNorio TadaDove Medical Pressarticlegallium-67 scintigraphypolymyalgia rheumaticapseudogoutreactive arthritisRS3PE syndrome.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 4, Pp 391-395 (2009)
institution DOAJ
collection DOAJ
language EN
topic gallium-67 scintigraphy
polymyalgia rheumatica
pseudogout
reactive arthritis
RS3PE syndrome.
Geriatrics
RC952-954.6
spellingShingle gallium-67 scintigraphy
polymyalgia rheumatica
pseudogout
reactive arthritis
RS3PE syndrome.
Geriatrics
RC952-954.6
Hidekatsu Yanai
Hiroshi Yoshida
Norio Tada
Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
description Hidekatsu Yanai1,2, Hiroshi Yoshida2,3, Norio Tada1,21Division of General Medicine, Department of Internal Medicine, The Jikei University School of Medicine, Kashiwa, Japan; 2Institute of Clinical Medicine and Research, The Jikei University School of Medicine, Chiba, Japan; 3Department of Laboratory Medicine, The Jikei University School of Medicine, Kashiwa, JapanAbstract: To find out clues to differentiate between polymyalgia rheumatica (PMR) and other diseases that mimic PMR. We studied Japanese patients with PMR (n = 7), pseudogout (n = 1), remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome (n = 1), and post-infectious polyarthritis (n = 1). The distribution of inflammation in patients was evaluated using a gallium-67 scintigraphy. We measured serum C-reactive protein (CRP), matrix metalloproteinase- 3 (MMP-3), and vascular endothelial growth factor (VEGF) in patients before and after treatment. Further, we compared the clinical course of PMR with that of other diseases that mimic PMR. Patients with pseudogout, RS3PE syndrome, post-infectious polyarthritis manifested similar changes in scintigraphic findings and serum CRP, MMP-3, and VEGF levels to PMR before the treatment. A significant reduction in serum CRP levels at one week after use of nonsteroidal anti-inflammatory drugs (NSAIDs) is a good clue to differentiate pseudogout and post-infectious polyarthritis from PMR. Chondrocalcinosis in the radiographs of joints is also effective to differentiate pseudogout from PMR. A small reduction of CRP levels after NSAIDs use and promptly ameliorated CRP and symptoms by a low-dose steroid therapy, which was commonly observed in patients with PMR, were also found in a patient with RS3PE syndrome. Pitting edema of the back of hands and gallium uptake in metacarpophalangeal (MCP) joints were useful to differentiate RS3PE syndrome from PMR. In conclusion, pseudogout, RS3PE syndrome, post-infectious polyarthritis should be included in the spectrum of diseases mimicking PMR. A promptly decreased serum CRP level by NSAIDs is a good clue to differentiate pseudogout and post-infectious polyarthritis from PMR. Pitting edema of the back of hands and symmetric gallium uptake in MCP joints are characteristic for RS3PE syndrome.Keywords: gallium-67 scintigraphy, polymyalgia rheumatica, pseudogout, post-infectious polyarthritis, RS3PE syndrome
format article
author Hidekatsu Yanai
Hiroshi Yoshida
Norio Tada
author_facet Hidekatsu Yanai
Hiroshi Yoshida
Norio Tada
author_sort Hidekatsu Yanai
title Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
title_short Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
title_full Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
title_fullStr Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
title_full_unstemmed Clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
title_sort clinical, radiological, and biochemical characteristics in patients with diseases mimicking polymyalgia rheumatica
publisher Dove Medical Press
publishDate 2009
url https://doaj.org/article/ae108a9796da49b6966420de523dfbfc
work_keys_str_mv AT hidekatsuyanai clinicalradiologicalandbiochemicalcharacteristicsinpatientswithdiseasesmimickingpolymyalgiarheumatica
AT hiroshiyoshida clinicalradiologicalandbiochemicalcharacteristicsinpatientswithdiseasesmimickingpolymyalgiarheumatica
AT noriotada clinicalradiologicalandbiochemicalcharacteristicsinpatientswithdiseasesmimickingpolymyalgiarheumatica
_version_ 1718401210169425920