[Rheumatic polymyalgia: the state of the problem].
The aim of the study was to analyze literature data on the etiology, pathogenesis, and clinical criteria of rheumatic polymyalgia (RP) as well as present-day possibilities of the treatment and monitoring of the disease. Today, RP is considered to belong to the group of system vasculites. The disease affects the elderly. No specific bacterial or viral etiological factors have been revealed. In 5 to 10% cases RP is combined with temporal arteritis (Horton's disease), although morphological changes in the temporal artery are found in 40% of RP patients. The clinical manifestation is unique; it includes pronounced myalgia in the upper brachial girdle, the pelvic girdle, and the neck, as well as increased ESR. Treatment with glucocorticoids (GK) in low doses has very quick positive effect. Gradual cancel of GK is artwork; to make it possible, B. Leeb and H. Bird developed the activity index (RPAI) in 2003. An RPAI of less than 7 is considered the target value. The length of GK administration depends on the severity of RP and the adequacy of dose lowering gradient. Thus, the clinical diagnosis of RP is not difficult; the monitoring of the disease should be performed using RPAI, trying to achieve its target value.
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D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy