In the Department of Rheumatology and Immunology, there is a clinically common but often misdiagnosed disease called polymyalgia rheumatica. This is an autoimmune disease that occurs more frequently in people over the age of 50, and the incidence in women can be 2-3 times that of men.
The onset is more urgent, manifested by sudden muscle pain, morning stiffness, and movement disorders in the neck, shoulders, hips (thigh roots), etc., which can be accompanied by unexplained symptoms of persistent low-grade fever, anemia, fatigue, decreased appetite, and weight loss.
However, due to rheumatic polymyalgia and rheumatoid arthritis, frozen shoulder, fibromyalgia syndrome and other diseases, there are similar muscle pain, weakness, limited mobility and other symptoms.
At present, there is no specific laboratory test to confirm the diagnosis, and only with the help of inflammatory indicators such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), as well as ultrasound, magnetic resonance examination and other auxiliary diagnosis.
Therefore, if you want to diagnose polymyalgia rheumatica, you often need to first exclude rheumatoid arthritis, frozen shoulder, fibromyalgia syndrome, tumors and other diseases, which often have their own characteristics:
In addition, polymyalgia rheumatica may also be a precursor to neoplastic diseases, especially in the case of wasting in a short period of time, and it is necessary to actively seek medical examination.
Polymyalgia rheumatica does not heal spontaneously and should be treated as soon as possible once it is diagnosed
The preferred drug for the treatment of polymyalgia rheumatica is glucocorticoids, such as prednisone acetate and methylprednisolone, which are used in small doses and have a good effect, and symptoms can be significantly improved after taking the drug for two or three days.
However, due to the fact that polymyalgia rheumatica is a chronic disease that often requires long-term medication, it may bring some side effects of hormonal drugs, such as weight gain, bone mass loss, increased blood pressure, increased blood sugar, and increased risk of infection.
You can take calcium and vitamin D3 at the same time during the medication to slow down the loss of calcium, and closely monitor your blood pressure and blood sugar.
In addition to glucocorticoids, nonsteroidal analgesic and anti-inflammatory drugs such as acetaminophen and indomethacin can be used to relieve pain, and the drug can be discontinued after symptom relief.
If glucocorticoid therapy is not effective, the condition is repeated, and the hormone reduction is difficult, the combination of immunosuppressants may be selected, such as methotrexate, leflunomide, etc.
However, it should be noted that long-term use of immunosuppression may also cause a decrease in resistance, liver and kidney function is affected, and the risk of infection is increased, and it must be used under the guidance of a doctor.
Rheumatic polymyalgia medication cycle is relatively long, may take 3-5 years, during the medication should be taken according to the doctor's instructions, do not reduce the drug, stop the drug, otherwise it may not be able to achieve the desired treatment effect.
Moreover, autoimmune diseases are usually volatile, sometimes light and heavy, sometimes good and sometimes bad, so it is necessary to pay attention to review during taking drugs and even after cure.
Generally, after the initial treatment, a follow-up consultation is required every 1 month or so, and after the condition is relieved, the follow-up consultation can be observed every 6-12 months to observe the progression of the disease.
Since taking glucocorticoids may cause some changes in blood pressure and blood sugar, it is recommended that patients usually have a low-salt, low-sugar, and low-fat diet, but it is not recommended to smoke and drink alcohol. After the disease is relieved, it should also be active, and daily attention should also be paid to keeping warm and avoiding injuries.
References: Medical Microvision official website - Deng Xuerong, Chief Physician of "Polymyalgia Rheumatics"