CHECK-UP:Is there a link between giant cell arteritis and polymyalgia rheumatica?
WHAT IS polymyalgia rheumatica? I was already diagnosed and treated for giant cell arteritis but have gone on to develop this second condition, PMR. Is there a link?
Polymyalgia rheumatica (PMR) is a disorder which results in pain and stiffness in the muscles of the neck, shoulders and hips.
Stiffness tends to occur in the mornings and after periods of inactivity.
Although the cause of the condition is unknown, it appears to be associated with immune system problems – perhaps a genetic tendency towards the illness which is then triggered by an infection.
While rare under the age of 50 it becomes more common after this time so it may be linked to the ageing process.
Giant cell arteritis (GCA) is a disorder in which there is inflammation of arteries of the temples, scalp, neck and arms. The inflammation causes the arteries to narrow, which in turn impedes blood flow. Also known as temporal arteritis, headache is the most common symptom.
In some sufferers, pain on chewing, blurred or reduced vision or, in rare cases, blindness may occur.
While it is unclear how PMR and GCA are related, they do frequently affect the same person.
Like PMR, GCA tends to develop after the age of 50 with the incidence peaking for both conditions between the ages of 70 and 80 years.
My doctor started me on treatment first and then sent me for a biopsy to confirm I had GCA. Why did she do this?
Where GCA is suspected, a biopsy of a small section of the artery is removed and examined under microscope.
However, it is important that treatment start as quickly as possible, as if GCA is not treated promptly there is a small risk of blindness developing.
To reduce this risk, a doctor will start treatment on the basis of a physical examination and reported symptoms, even before confirmation of the diagnosis through biopsy.
While treatment for both conditions is corticosteroid medications, a non-steroidal anti-inflammatory drug may be used to ease the symptoms of PMR.
With treatment, symptoms can be relieved in a relatively short time and once under control, the dose of corticosteroid is reduced gradually over time.
Although polymyalgia rheumatica may recur, symptoms can be re-treated with steroids.
Once giant cell arteritis is treated effectively, it rarely recurs. Most people with GCA and PMR lead active, productive lives.