[Polymyalgia rheumatica and giant cell arteritis: recent data and current situation].
Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are two frequently linked inflammatory diseases of the elderly. The diagnosis of GCA is based on temporal artery biopsy, but results must not delay steroid therapy because of the potential sudden ocular and neurologic ischemic complications. PET-scan and MRI angiography can be helpful in difficult cases. The diagnosis of PMR is essentially clinical, centred on subacute onset of morning aching and stiffness in the shoulder and hip girdles. The treatment of both entities is still based on glucocorticoids (10-20 mg/j of prednisone for PMR, and 40-60 for GCA). Methotrexate, though, now appears a sometimes-useful corticosteroid-sparing agent, both in PMR and GCA. There also appears to be a role for low dose aspirin to decrease ischemic events in GCA.
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Division de rhumatologie, HUG, Beau-Séjour 1211 Genève.
Guerne
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PA
D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000639:trends; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D011111:Polymyalgia Rheumatica / Q000175:diagnosis* / Q000628:therapy*