Although there is no cure for either condition, the good news is that both disorders respond rapidly to prednisone or a related drug and, when adequately treated, will eventually go away. In fact, prednisone is so effective that if symptoms are not relieved within a few days when a proper dose is taken, chances are the diagnosis is incorrect.
Polymyalgia rheumatica, or PMR, more commonly afflicts women — most often Caucasians. The average age of onset is 70 and it rarely occurs in people younger than 50. No one knows why a person’s immune system suddenly attacks the body’s own connective tissue, although genetics are believed to play a role and an infection may be the precipitating factor.
It’s a tricky diagnosis because the symptoms, which may start gradually or suddenly, can resemble a lot of different conditions. As Ms. Uffner experienced, PMR typically starts with pain and stiffness in the hips, thighs, neck, upper arms and shoulders that is most severe in the morning or following other prolonged periods of inactivity. Weakness and fatigue soon follow, sometimes accompanied by a mild fever, poor appetite and weight loss.
Making the correct diagnosis is a process of elimination. Many blood tests are done to rule out conditions like rheumatoid arthritis, lupus, Lyme disease, vasculitis, various muscle and infectious diseases, hormone abnormalities and even cancer.
Once PMR is diagnosed, it’s also important for patients to be checked for signs of temporal arteritis. If someone has symptoms suggestive of arteritis, a biopsy of the temporal artery on the side of the head may be needed to confirm the diagnosis.
The symptoms of temporal arteritis are not nearly as confusing. They result from inflammation of the temporal arteries that feed blood to the head, and that’s nearly always where it hurts the most. Patients may also have scalp tenderness, vision changes or soreness of the face or jaw, especially when chewing. Other possible symptoms include feeling sick, fever, fatigue and achy arms or legs. The most serious complication is a stroke, which afflicts about one person in 20 who has temporal arteritis.
Steroids like prednisone work by curbing the function of inflammatory cells that are the hallmarks of both disorders. But the medication has its own challenges. While it can give patients an energy boost, it also stimulates the appetite and fosters water retention, causing facial and abdominal bloating and weight gain.
Source : Nytimes
