风湿性多肌痛
医学
巨细胞动脉炎
泼尼松龙
滑囊炎
甲氨蝶呤
内科学
动脉炎
人口
胃肠病学
疾病
血管炎
皮肤病科
外科
环境卫生
作者
Miguel Á. González‐Gay,Michael Schirmer,Santos Castañeda
出处
期刊:The Lancet
[Elsevier]
日期:2017-07-31
卷期号:390 (10103): 1700-1712
被引量:209
标识
DOI:10.1016/s0140-6736(17)31825-1
摘要
Polymyalgia rheumatica is an inflammatory disease that affects the shoulder, the pelvic girdles, and the neck, usually in individuals older than 50 years. Increases in acute phase reactants are typical of polymyalgia rheumatica. The disorder might present as an isolated condition or in association with giant cell arteritis. Several diseases, including inflammatory rheumatic and autoimmune diseases, infections, and malignancies can mimic polymyalgia rheumatica. Imaging techniques have identified the presence of bursitis in more than half of patients with active disease. Vascular uptake on PET scans is seen in some patients. A dose of 12·5-25·0 mg prednisolone daily or equivalent leads to rapid improvement of symptoms in most patients with isolated disease. However, relapses are common when prednisolone is tapered. Methotrexate might be used in patients who relapse. The effectiveness of biological therapies, such as anti-interleukin 6, in patients with polymyalgia rheumatica that is refractory to glucocorticoids requires further investigation. Most population-based studies indicate that mortality is not increased in patients with isolated disease.
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