Atypical clinical course of polymyalgia rheumatica
Abstract. The article presents two clinical cases of atypical polymyalgia rheumatica (PR). The first case describes a female patient with pain localized in only one anatomical region, also it was a delayed increase in inflammatory markers (erythrocyte sedimentation rate and C-reactive protein) after the PR onset. An interesting feature of the second case is the absence of elevated inflammatory markers specific to the typical course of PR. To establish a preliminary diagnosis, the diagnostic criteria for PR such as Bird H.A. et al. (in both cases) and EULAR/ACR classification criteria (in the second case) were used, even taking into account the atypical course of the disease. The final diagnosis was made basing on the response to glucocorticoid therapy and subsequent dynamic observation of the patients (females). The aim of the study is to demonstrate the diversity of clinical variants of PR, which is important not only for rheumatologists but also for specialists of other specialties who may also encounter this pathology in their practice.S.N. Marshal, M.D. Iarovoy, I.V. Semenyakin, E.V. Reznik
Keywords
polymyalgia rheumatica
bursitis
arthralgia
rheumatological diseases
osteoarthritis
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About the Authors
Sergey N. Marshala, MD, general practitioner, rheumatologist, assistant at the Department of internal medicine propaedeutics No. 2, Institute of Clinical Medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation.E-mail: marshala_2011@mail.ru
ORCID: https://orcid.org/0009-0004-9738-7447
Maksim D. Iarovoy, 5th-year student of the Faculty of general medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation.
E-mail: jarovojmax@mail.ru
ORCID: https://orcid.org/0009-0008-4580-8851
Igor V. Semenyakin, MD, Dr. Sci. (Medicine), professor, medical director of MEDSI Group of Companies JSC, Moscow, Russian Federation.
E-mail: semeniakin.iv@medsigroup.ru
ORCID: https://orcid.org/0000-0003-3246-7337
Elena V. Reznik, MD, Dr. Sci. (Medicine), head of the Department of internal medicine propaedeutics No. 2, Institute of Clinical Medicine, Pirogov Russian National Research Medical University, Moscow, Russian Federation.
E-mail: reznik_ev@rsmu.ru
ORCID: https://orcid.org/0000-0001-7479-418X
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