Whipple disease mimicking polymyalgia rheumatica with initial response to tocilizumab

2021 ◽  
Vol 51 (12) ◽  
pp. 2151-2152
Author(s):  
Loic Meudec ◽  
Germain Jelin ◽  
Julia Goossens ◽  
Marine Forien ◽  
Hervé Jacquier ◽  
...  
Keyword(s):  
Polymyalgia Rheumatica ◽  
Initial Response ◽  
Whipple Disease

scholarly journals Neutrophil to Lymphocyte Ratio Predicts Glucocorticoid Resistance in Polymyalgia Rheumatica: A Prospective Study

2020 ◽  
Author(s):  
Claire Owen ◽  
Christopher McMaster ◽  
David FL Liew ◽  
Jessica L Leung ◽  
Andrew M Scott ◽  
...  
Keyword(s):  
Disease Activity ◽  
Polymyalgia Rheumatica ◽  
Linear Regression Analysis ◽  
Initial Response ◽  
Primary Outcome Measure ◽  
Neutrophil To Lymphocyte Ratio ◽  
Glucocorticoid Resistance ◽  
Newly Diagnosed ◽  
Lymphocyte Ratio ◽  
The Relationship

Abstract Background Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been found to correlate with disease activity in several rheumatic diseases, however their clinical and prognostic utility in polymyalgia rheumatica (PMR) remains unclear. This study evaluated the relationship between NLR and PLR, and disease activity and glucocorticoid resistance in PMR. Methods Data for disease activity (PMR-AS) and full blood examination was obtained from a prospective observational cohort comprising newly diagnosed (2012 EULAR/ACR classification criteria), steroid-naïve PMR patients treated with low-dose glucocorticoid therapy (BSR guideline). Glucocorticoid resistance was defined as non-response to initial prednisolone dose (15mg/day) or initial response followed by flare (PMR-AS ≥9.35 or ∆≥6.6) upon weaning prednisolone to 5mg/day. Univariable Bayesian linear regression analysis of the relationship between PMR-AS (baseline and mean) and NLR and PLR was performed. Predictors of glucocorticoid resistance were identified using a multivariable outcome model, with variables chosen based upon Bayesian model selection. Results Of the 32 included patients, 16 (50%) fulfilled the primary outcome measure of glucocorticoid resistance. These participants were older, typically female, and had higher baseline CRP than their glucocorticoid-responsive counterparts. A statistically significant relationship was identified between PMR-AS and both NLR (OR 28.1 [95% CI 1.6 – 54.7]) and PLR (OR 40.6 [95% CI 10.1 – 71.4]) at baseline, with PLR also found to correlate with disease activity during follow-up (OR 15.6 [95% CI 2.7 – 28.2]). Baseline NLR proved to be a statistically significant predictor of glucocorticoid-resistant PMR (OR 14.01 [95% CI 1.49 – 278.06]). Conclusion Baseline NLR can predict glucocorticoid resistance in newly diagnosed PMR patients. Both NLR and PLR may be reliable biomarkers of disease activity in PMR.

81-jährige Patientin mit bewegungstherapieresistenten Schmerzen der oberen Extremitäten

Praxis ◽  
2006 ◽  
Vol 95 (45) ◽  
pp. 1768-1770
Author(s):  
von Garnier ◽  
Bär ◽  
Daikeler ◽  
Rafeiner
Keyword(s):  
Polymyalgia Rheumatica ◽  
Klinische Beurteilung

81-jährige Patientin mit sechsmonatigen Schmerzen der oberen Extremitäten, welche am ehesten mit einer atypischen Polymyalgia rheumatica vereinbar sind und gut auf eine Behandlung mit Steroiden ansprechen. Eine gute klinische Beurteilung ist zur Abgrenzung der Polymyalgia rheumatica von der Riesenzell-arteriitis (GCA) sowie von anderen Differentialdiagnosen unerlässlich und bildet die Grundlage einer kontrollierten Behandlung mit Glukokortikoiden.

Besonderheiten der medikamentösen Therapie von Polymyalgia rheumatica und rheumatoider Arthritis im höheren Lebensalter

2014 ◽  
Vol 34 (05) ◽  
pp. 283-288
Author(s):  
J. Wollenhaupt
Keyword(s):  
Polymyalgia Rheumatica

ZusammenfassungDie Diagnose der rheumatoiden Arthritis im höheren Lebensalter ist aufgrund eines häufiger atypischen klinischen Symptombildes oft erschwert. Die Polymyalgia rheumatica (PMR) weist demgegenüber zwar charakteristische Beschwerden auf, wird allerdings heute eher als Bursitis-Myalgie-Syndrom mit erhöhten Entzündungsparametern auf dem Boden einer Vaskulitis verstanden. Die Therapie basiert auf dem zurückhaltenden Einsatz von Glukokortikoiden und einer angepassten, gezielt dosierten und überwachten Behandlung mit Methotrexat. In therapierefraktären Fällen stehen neben konventionellen Therapeutika auch Biologika zur Verfügung.

Rapidly progressive glomerulonephritis as presenting feature of systemic lupus erythematosus in a Bangladeshi male patient: a rare case report

2020 ◽  
Vol 10 (2) ◽  
pp. 137-138
Author(s):  
Samiha Haque ◽  
Ishrat Jahan ◽  
Tufayel Ahmed Chowdhury ◽  
Muhammad Abdur Rahim ◽  
Mehruba Alam Ananna ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Venous Pressure ◽  
Rapidly Progressive Glomerulonephritis ◽  
Initial Response ◽  
Systemic Lupus ◽  
Renal Manifestation ◽  
Rare Case Report ◽  
Diagnostic Work ◽  
Work Up

Rapidly progressive glomerulonephritis is one of the most dramatic and tragic presentations of lupus nephritis (LN) or renal manifestation of systemic lupus erythematosus (SLE). A 35-year-old Bangladeshi gentleman presented with worsening oedema, scanty, high colored, frothy urine and deteriorating renal function. He had puffy face, anaemia, oedema, normal jugular venous pressure (JVP), high blood pressure (150/90 mm Hg), ascites and bilateral pleural effusions. Diagnostic work-up confirmed SLE with class IV LN. His initial response to specific therapy showed improvement Birdem Med J 2020; 10(2): 137-138

EFFECTS OF SYNTHETIC LH/FSH-RELEASING HORMONE (LRH) ON PLASMA LH AND FSH IN AMENORRHOEIC WOMEN

1974 ◽  
Vol 75 (4) ◽  
pp. 647-652 ◽  
Author(s):  
G. Rannevik ◽  
J. Thorell
Keyword(s):  
Urinary Excretion ◽  
Initial Response ◽  
Releasing Hormone ◽  
The Mean ◽  
The Difference ◽  
Serial Measurements

ABSTRACT Eight amenorrhoeic women were given 100 μg synthetic LRH (Hoechst) iv and im, respectively, at an interval of 2 weeks. Four of the women received the iv injection first and four the im injection. The urinary excretion of oestrogens and pregnanediol was low and unaltered throughout the test weeks. The effects of LRH were compared by serial measurements of the plasma LH and FSH during 8 h. The initial response of LH for up to 25 min and that of FSH for up to 60 min were equal whether LRH was given iv or im. The difference appeared later. Four hours after the injection the mean increase of LH to iv injection was 0.5 ng/ml (N. S.), while that to im injection was 1.9 ng/ml (P < 0.01). The corresponding values for FSH were 1.3 (P < 0.05) and 3.2 (P < 0.001). The effect of LRH administration im was thus found to be larger and more prolonged.

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