title: The clinical course of polymyalgia rheumatica in Chinese.
abstract: Polymyalgia rheumatica (PMR) is diagnosed based on clinical features that may overlap with other rheumatic conditions like rheumatoid arthritis (RA). Furthermore, a proportion of PMR patients may subsequently evolve into RA. The aim of this study was to examine the clinical characteristics of PMR patients in a Chinese cohort compared to a Caucasian series. Patients diagnosed to have PMR during 1997-2008 were reviewed for clinical features and compared to a reported Caucasian series. Rheumatoid factor (RF) and anticyclic citrullinated peptide (CCP) antibodies were determined by immunonephelometry and enzyme-linked immunosorbent assay, respectively. Forty-four patients of southern Chinese origin were diagnosed to have PMR according to specialist opinion. Seventy-five percent of patients (n = 33) were >65 years of age at diagnosis (mean +/- standard deviation, 75.8 +/- 9.6 years). The commonest feature at disease onset was elevated erythrocyte sedimentation rate >40 mm/h (100% vs. 95.7%; p = 0.17) and bilateral shoulder pain or stiffness (95.5% vs. 90.8%; p = 0.31), comparable in frequency to the Caucasian cohort. However, Chinese patients had significantly longer duration of symptoms before diagnosis (p < 0.001) but less bilateral upper arm tenderness (p < 0.001) and generalized stiffness (p = 0.01). Twelve (27.3%) patients evolved into RA after a median duration of 2 months from onset of PMR. RF and anti-CCP antibodies were positive in 66.7% and 60% of these patients compared to 9.4% and 6.2%, respectively, among those who did not evolve into RA during the period observed. Chinese patients with PMR have modestly different clinical profile compared to the Caucasian counterpart. RF and anti-CCP antibodies were more likely to be present in those who subsequently developed into RA.
authors.affiliation: Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
authors.forename: Wai Ling
authors.initials: WL
authors.lastname: Li
authors.forename: Yi
authors.initials: Y
authors.lastname: Lo
authors.forename: Moon Ho
authors.initials: MH
authors.lastname: Leung
authors.forename: Woon Sing
authors.initials: WS
authors.lastname: Wong
authors.forename: Mo Yin
authors.initials: MY
authors.lastname: Mok
mesh_terms: D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis; D044466:Asian People; D001323:Autoantibodies / Q000097:blood; D001799:Blood Sedimentation / Q000187:drug effects; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D011239:Prednisolone / Q000627:therapeutic use*; D012217:Rheumatoid Factor / Q000097:blood; D018709:Statistics, Nonparametric; D044465:White People / Q000208:ethnology
chemical_list: D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D012217:Rheumatoid Factor; D011239:Prednisolone