Summary
There is no unanimity as to whether polymyalgia rheumatica (PMR) and temporal arteritis (TA) are two distinct diseases or different features of one disease.
The objective of this study was to assess the value of histological findings of temporal artery biopsy and the efficacy and complications of drug therapy as well as the frequency of malignancies. It was carried out as a retrospective follow-up study. One hundred eleven patients (89 PMR, 14 TA and 8 PMR+TA) were studied. In 56 patients with PMR a temporal artery biopsy was performed; in none of these biopsies was active arteritis found. Of the 19 patients with TA or PMR+TA, where a temporal artery biopsy was performed, arteritis was found in 15 patients. Reactivation occurred in 27 patients: 4 patients using NSAIDs and 23 patients using corticosteroids. Side effects of the medication included vertebral compression in 10 patients, most of whom were using corticosteroids.
Malignancies were diagnosed in 12 of the 111 patients. Most malignancies were diagnosed long before or after the diagnosis of PMR.
In case of a PMR diagnosed by the clinician a biopsy of the temporal artery has no value, while the yield of this diagnostic procedure is high in TA. Reactivation was seen quite often and warrants a prolonged period of medical treatment.
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Janssen, M., Rasker, J.J., Festen, J.J., Hulst, S.G.Th. Polymyalgia rheumatica, a box of Pandora? Ned Tijdschr Geneesk 1981, 125, 575–583.
Chuang, T., Hunder, G.G., Ilstrup, D.M., Kurland, L. Polymyalgia rheumatica. A 10-year epidemiology and clinical study. Ann of Int Med 1982, 97, 672–680.
Hamrin, B. Polymyalgia arteritica. Acta Med Scand (suppl) 1972, 533, 1–131.
Sørensen, P.S., Lorenzen, I. Giant cell arteritis temporal arteritis and polymyalgia rheumatica. Acta Med Scand 1977, 201, 207–213.
Bengtsson, B.A., Malmvall, B.E. Prognosis of giant cell arteritis including temporal arteritis and polymyalgia rheumatica. Acta Med Scand 1981, 201, 337–345.
Fauchald, P., Rygvold, O., Oystese, B. Temporal arteritis and polymyalgia rheumatica clinical and biopsy findings. Ann Intern Med 1972, 77, 845–852.
Goodman, B.W. Temporal arteritis. Am J Med 1979, 67, 839–852.
Bird, H.A., Esselinckx, W., Dixon, A.S.J., Mowat, A.G., Wood, P.H.N. An evaluation of criteria for polymyalgia rheumatica. Ann Rheum Dis 1979, 38, 434–439.
Fernandez-Herlily, L. Temporal arteritis: clinical aids to diagnoses. J Rheumatol 1988, 15, 1797–1801.
Delecoeillerie, G., Joly, P., Cohen de Lara, A., Paolaggi, J.B. Polymyalgia rheumatica and temporal arteritis: a retrospective analysis of progrnostic features and different corticosteroid regimens (11 year survey of 210 patients). Ann Rheum Dis 1988, 47, 733–739.
Huston, K.A., Hunder, G., Lie, J.T., Kennedy, R., Elveback, L.R. Temporal arteritis. A 25-year epidemiologic, clinical and pathologic study. Ann Int Med 1988, 88, 162–168.
Machleder, H.J. Vascular disorders of the upper extremity. 1983, 214–223.
Hazleman, B., Bengtsson, B.A. Giant cell arteritis. Baillieres Clin Rheumatol 1991, 5, 372–374.
Jonkhoff, A.R., Gans, R.O.B. Reuzencel-arteritis, meer dan arteriitis temporalis alleen. Ned Tijdschr Geneesk 1991, 135, 41–45.
Bernelot Moens, H.J., van der Korst, K.J. Polymyalgia rheumatica: afbakening van een ziektebeeld. Ned Tijdschr Geneesk 1985, 129, 1272–1275.
Hall, S., Hunder, G.G. Is temporal artery biopsy prudent? Mayo Clinic Proc 1984, 59, 793–796.
Healey, L.A., Sheets, P.K. The relationship of polymyalgia rheumatica to rheumatoid arthritis. J Rheum 1988, 15, 750–752.
O'Duffy, J.D., Wahner, H., Hunder, G.G. Joint imaging in polymyalgia rheumatica. Mayo Clinic Proc 1976, 51, 519–524.
Wise, C.M., Aqudelo, C.A., Chemelewski, W.L., McKnight, K.M. Temporal arteritis with low erythrocyte sedimentation rate: a review of five cases. Arthritis Rheum 1991, 34, 1571–1574.
Hunder, G.G., Michet, C.J. Giant cell arteritis and polymyalgia rheumatica. Clin Rheum Dis 1985, 11, 471–483.
Maaten, J.C. ter, van der Kaa, C.A., Hoorntje, S.J., Hillen, H.F.P. Diagnostic procedures and prognosis of polymyalgia rheumatica and temporal arteritis. Ned Tijdschr Geneesk 1991, 135, 64–68.
Von Knorring J. Treatment and prognosis in polymyalgia rheumatica and temporal arteritis: a ten-year survey of 53 patients. Acta Med Scand 1979; 205: 429–35.
Myles, A.B., Perera, T., Ridley, M.G. Prevention of blindness in giant cell arteritis by corticosteroïd treatment. Br J Rheum 1992, 31, 103–105.
Mertens, J.C.C., Dissel, J.T. van, Kibbelaar, R.E., Breedveld, F.C. The clinical spectrum of giant cell arteritis. Neth J Med 1993, 42, 99–104.
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Mertens, J.C.C., Willemsen, G., Van Saase, J.L.C.M. et al. Polymyalgia rheumatica and temporal arteritis: A retrospective study of 111 patients. Clin Rheumatol 14, 650–655 (1995). https://doi.org/10.1007/BF02207931
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DOI: https://doi.org/10.1007/BF02207931