title: Polymyalgia rheumatica in a patient with splenic marginal zone lymphoma - a case report.
abstract: Polymyalgia rheumatica (PMR) is a common inflammatory disease in elderly people. We present a case of a 49-year-old woman diagnosed with PMR. The treatment with prednisone resulted in a rapid resolution of clinical symptoms. However, inflammatory markers remained elevated. Ultrasonography and computed tomography revealed the presence of a large splenic lesion. A cyst was suspected but, because of the high risk of splenic rupture, a splenectomy was performed. The histopathological examination revealed the presence of splenic marginal zone lymphoma. Inflammatory markers returned to normal after splenectomy. Prednisone was tapered but clinical symptoms of PMR reappeared after lowering the dose of prednisone <10 mg/day. Thus, treatment with methotrexate was started, which allowed for further tapering of prednisone.
authors: Military Institute of Medicine, Warszawa, Poland: Department of Internal Diseases and Rheumatology.
authors: Bartłomiej
authors: B
authors: Kisiel
authors: Military Institute of Medicine, Warszawa, Poland: Department of Internal Diseases and Hematology.
authors: Krzysztof
authors: K
authors: Gawroński
authors: Military Institute of Medicine, Warszawa, Poland: Department of Internal Diseases and Hematology.
authors: Piotr
authors: P
authors: Rzepecki
authors: Military Institute of Medicine, Warszawa, Poland: Department of Internal Diseases and Rheumatology.
authors: Witold
authors: W
authors: Tłustochowicz
mesh_terms: D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000008:administration & dosage; D012008:Recurrence; D013156:Splenectomy; D013160:Splenic Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
chemical_list: D011241:Prednisone; D008727:Methotrexate
keywords: glucocorticoids; methotrexate; polymyalgia rheumatica; splenic marginal zone lymphoma