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Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report

We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck, shoulders, and pelvic girdle that lasted for 45 minutes each morning upon waking. Due to clinical suspicion of polymyalgia rheumatica (PMR)...

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Detalles Bibliográficos
Autores principales: Gay, Carter, Kihara, Colby, Oakley, Katie, Patel, Arsh N, Akinsoto, O.P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724594/
https://www.ncbi.nlm.nih.gov/pubmed/36483895
http://dx.doi.org/10.7759/cureus.31159
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author Gay, Carter
Kihara, Colby
Oakley, Katie
Patel, Arsh N
Akinsoto, O.P.
author_facet Gay, Carter
Kihara, Colby
Oakley, Katie
Patel, Arsh N
Akinsoto, O.P.
author_sort Gay, Carter
collection PubMed
description We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck, shoulders, and pelvic girdle that lasted for 45 minutes each morning upon waking. Due to clinical suspicion of polymyalgia rheumatica (PMR), the patient was started on the standard therapy of low-dose glucocorticoid therapy and was noted to have a dramatic improvement in terms of pain, strength, mobility, and range of motion. Current literature shows high variability in the standard response time to treatment. Typical resolution of symptoms occurs within a span of one day to months. The case presented in our study shows symptom resolution as well as marked improvement in muscle strength and mobility within 12 hours. The purpose of this case report is to provide additional information for physicians when considering symptom-resolution time related to low-dose glucocorticoid therapy and PMR. Additionally, we briefly explore the literature on the correlation between giant cell arteritis (GCA) and glucocorticoid therapy for PMR as well as the data associated with adjuvant therapy using immunomodulatory treatment.
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spelling pubmed-97245942022-12-07 Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report Gay, Carter Kihara, Colby Oakley, Katie Patel, Arsh N Akinsoto, O.P. Cureus Internal Medicine We present a unique case of a 75-year-old Caucasian female who presented with a two-month history of unrelenting proximal muscle pain and stiffness in the neck, shoulders, and pelvic girdle that lasted for 45 minutes each morning upon waking. Due to clinical suspicion of polymyalgia rheumatica (PMR), the patient was started on the standard therapy of low-dose glucocorticoid therapy and was noted to have a dramatic improvement in terms of pain, strength, mobility, and range of motion. Current literature shows high variability in the standard response time to treatment. Typical resolution of symptoms occurs within a span of one day to months. The case presented in our study shows symptom resolution as well as marked improvement in muscle strength and mobility within 12 hours. The purpose of this case report is to provide additional information for physicians when considering symptom-resolution time related to low-dose glucocorticoid therapy and PMR. Additionally, we briefly explore the literature on the correlation between giant cell arteritis (GCA) and glucocorticoid therapy for PMR as well as the data associated with adjuvant therapy using immunomodulatory treatment. Cureus 2022-11-06 /pmc/articles/PMC9724594/ /pubmed/36483895 http://dx.doi.org/10.7759/cureus.31159 Text en Copyright © 2022, Gay et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Gay, Carter
Kihara, Colby
Oakley, Katie
Patel, Arsh N
Akinsoto, O.P.
Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report
title Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report
title_full Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report
title_fullStr Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report
title_full_unstemmed Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report
title_short Variability of Steroid Response Time in Polymyalgia Rheumatica: A Case Report
title_sort variability of steroid response time in polymyalgia rheumatica: a case report
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724594/
https://www.ncbi.nlm.nih.gov/pubmed/36483895
http://dx.doi.org/10.7759/cureus.31159
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