Abstract
Background: Polymyalgia rheumatica (PMR) may create some difficulties in the differential diagnosis of elderly-onset rheumatoid arthritis (EORA) and of EORA with PMR-like onset (EORA/PMR). Aim: To investigate possible differences between...
Highlights
Polymyalgia rheumatica (PMR) may create some difficulties in the differential diagnosis of elderly-onset rheumatoid arthritis (EORA) and of EORA with PMR-like onset (EORA/PMR)
IL1 receptor antagonist (IL1Ra) serum levels were significantly higher in patients with EORA than in controls (p,0.001) and in patients with PMR and EORA/PMR (p,0.05)
Serum Tumour necrosis factor a (TNFa) and IL6 levels significantly decreased in all patient groups; IL1Ra significantly increased in patients with PMR and in those with EORA/PMR; cortisol, dehydroepiandrosterone sulphate (DHEAS), and PRG significantly decreased in patients with PMR and in those with EORA/PMR (p,0.05)
Summary
Polymyalgia rheumatica (PMR) may create some difficulties in the differential diagnosis of elderly-onset rheumatoid arthritis (EORA) and of EORA with PMR-like onset (EORA/PMR). Aim: To investigate possible differences between three groups of patients, with regard to serum levels of inflammatory cytokines and steroidal hormones at baseline and after 1 month of treatment with glucocorticoids (prednisone 7.5–12.5 mg/day). IL1Ra serum levels were significantly higher in patients with EORA than in controls (p,0.001) and in patients with PMR and EORA/PMR (p,0.05). Serum TNFa and IL6 levels significantly decreased in all patient groups; IL1Ra significantly increased in patients with PMR and in those with EORA/PMR; cortisol, DHEAS, and PRG significantly decreased in patients with PMR and in those with EORA/PMR (p,0.05). Conclusions: Different cytokine and steroidal hormone patterns suggest that patients with PMR and those with EORA/PMR seem to be have a more intensive inflammatory reaction and are more efficient responders to glucocorticoid treatment than patients with EORA
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