Polymyalgia rheumatica following paraspinal muscle inflammation and sacroiliitis
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Regarding etiology, the cause of PMR is still unknown. There are several reports about a genetic association involving genes for intercellular adhesion molecule 1, interleukin 1 receptor antagonist, and interleukin 6 [1]. There is no direct evidence for an infectious cause of PMR, although the incidence of PMR was reported to coincide with epidemics of Mycoplasma pneumoniae, parvovirus B19, and Chlamydia pneumoniae infections [1]. There is a report of three patients with PMR who weresuccessfully treated with the antibiotic clarithromycin. However, the authors considered that the effectiveness of clarithromycin in PMR was due to its anti-inflammatory effects, not its antibacterial activity [5]. There are reports that patients with PMR may have disturbances in the hypothalamic-pituitary-gonadal axis with some adrenal insufficiency, but this remains to be confirmed [1].
Abstract
Regarding etiology, the cause of PMR is still unknown. There are several reports about a genetic association involving genes for intercellular adhesion molecule 1, interleukin 1 receptor antagonist, and interleukin 6 [1]. There is no direct evidence for an infectious cause of PMR, although the incidence of PMR was reported to coincide with epidemics of Mycoplasma pneumoniae, parvovirus B19, and Chlamydia pneumoniae infections [1]. There is a report of three patients with PMR who weresuccessfully treated with the antibiotic clarithromycin. However, the authors considered that the effectiveness of clarithromycin in PMR was due to its anti-inflammatory effects, not its antibacterial activity [5]. There are reports that patients with PMR may have disturbances in the hypothalamic-pituitary-gonadal axis with some adrenal insufficiency, but this remains to be confirmed [1].
참고문헌 (5)
- Kermani TA, "Polymyalgia rheumatica", Lancet, 381, pp.63~72 (2013)
- Dasgupta B, "2012Provisional classification criteria for polymyalgia rheumatica:a European League Against Rheumatism", American College of Rheumatology collaborative initiative, 2012, pp.64, 943~954
- Sieper J, "The Assessment of SpondyloArthritis international Society (ASAS)handbook: a guide to assess spondyloarthritis", Ann Rheum Dis, 68(Suppl 2), pp.ii1~ii44 (2009)
- Olivieri I, "Late onset undifferentiated spondyloarthritis presenting with polymyalgia rheumatica features: description of seven cases", Rheumatol Int, 27, pp.927~933 (2007)
- Masashi Ohe, "Successful treatment with clarithromycin for patients with polymyalgia rheumatica", The Korean Journal of Internal Medicine, 29(4), pp.539~541 (2014), 대한내과학회[DOI]