SEARCH RESULTS FOR: Polymyalgia-Rheumatica

Polymyalgia Rheumatica

Polymyalgia Rheuma>ca: Pathogenesis and Clinical Outcomes The pathophysiology of Polymyalgia Rheuma9ca (PMR) is s9ll poorly understood. PMR is a rheuma9c condi9on characterized Author: Anna Bobyn Reviewers: Anika Zaman, Kevin Zhan Luiza Radu, Emily J. Doucette Glen Hazlewood* *MD at time of publication by pain and s9ffness around the neck, shoulder, and pelvic girdle. Non-Modifiable factors Assigned female at birth: 3♀ : 1♂ Environmental factors Age-Related Changes: PMR almost exclusively affects people >50 Polymorphisms: (eg. HLA-DR1, Interleukin (IL)-1, IL-6, TNF⍺) Infectious Triggers: Epstein-Barr virus, Mycoplasma pneumoniae, parvovirus Link to Vaccina=ons: COVID-19, influenza, respiratory syncy=al virus Innate immunity involvement: Macrophages & dendri=c cells recognize & respond to unknown an=gen Immune cells ↑ production of cytokines (IL-6, IFN-γ, TNF-α) Adap=ve immunity involvement: No strong evidence of autoan=body role Early CD4+ T cell ac=va=on & infiltra=on of T cells into vascular =ssue Subclinical vascular inflammation, particularly of medium & large arteries ↑ Vascular Endothelial Growth Factor & micro-vasculariza=on Vascular dysfunction, ischemia, edema, & sensitization of pain receptors Systemic inflamma=on Local inflamma=on of synovial membrane, joint bursae, & tendon sheaths B cell dysregula=on (↓ naïve B cells, ↑ memory B cells) ↑ Serum inflammatory markers (CRP & ESR) ↑ Risk of cardiovascular events (heart attack, stroke) Low-grade fever (37.2- 38°C) ↓ Passive & ac>ve range of mo>on Bilateral morning stiffness lasting >30 minutes Fa>gue & malaise Muscle pain in proximal joints (shoulder & pelvic girdle) Development of Giant Cell Arteri>s** (15-20% of PMR pa>ents) **See corresponding Calgary Guide slide Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complica=ons Published Mar 23, 2025 on www.thecalgaryguide.com