Table of Contents
- 1 Is CK high in PMR?
- 2 What blood tests show PMR?
- 3 How high is ESR in PMR?
- 4 What does polymyalgia pain feel like?
- 5 What causes polymyalgia rheumatica to flare up?
- 6 What is the best pain relief for polymyalgia?
- 7 What happens when creatine kinase is elevated in polymyalgia?
- 8 Can a elevated CRP level indicate polymyalgia rheumatica?
Is CK high in PMR?
The creatine kinase level is normal; this finding helps differentiate PMR from polymyositis and other primary myopathic disorders. Antinuclear antibodies, complement, rheumatoid factor, and anti-CCP levels are usually normal.
What blood tests show PMR?
The common blood tests to help diagnose PMR include:
- High Erythrocyte sedimentation (ESR)—can often be highly elevated and may exceed 100mm/hour in some cases (normal value—<30mm/hour)
- C-reactive protein (CRP)
- High liver enzymes.
What diseases can mimic polymyalgia rheumatica?
In addition to malignancy, other rheumatologic diseases are commonly mistaken for PMR [4–6]. These include rheumatoid arthritis, RS3PE syndrome, systemic lupus erythematosus, spondyloarthropathy, inflammatory myopathy, calcium pyrophosphate deposition disease, and vasculitides [4, 5].
Is CRP elevated in polymyalgia rheumatica?
The CRP is nearly always elevated in PMR. In two reports, an elevated ESR (greater than 30 mm/hour) was noted in 92 to 94 percent of patients at the time of diagnosis of PMR, while 99 percent of such patients had an increased serum CRP level (greater than 5 mg/L) [27,31].
How high is ESR in PMR?
In one study, 20 percent of patients had ESR values over 104 mm/hour . Conversely, several studies have found that in approximately 5 to 20 percent of patients with PMR, the ESR is less than 40 mm/hour [28-30]. The CRP is nearly always elevated in PMR.
What does polymyalgia pain feel like?
The signs and symptoms of polymyalgia rheumatica usually occur on both sides of the body and might include: Aches or pain in your shoulders. Aches or pain in your neck, upper arms, buttocks, hips or thighs. Stiffness in affected areas, particularly in the morning or after being inactive for a time.
Can you have PMR with normal blood tests?
Polymyalgia rheumatica can still be a very surprising disease: the diagnosis is possible even if normal values of both ESR and CRP are present.
How serious is polymyalgia?
If you have polymyalgia rheumatica, you are at a higher risk of getting a condition called giant cell arteritis (GCA). This involves inflammation of the blood vessels called arteries. This needs urgent treatment as there’s a risk of permanent loss of your eyesight or having a stroke with giant cell arteritis.
What causes polymyalgia rheumatica to flare up?
The cause of polymyalgia rheumatica (PMR) is unknown. It is possible that the way the immune system responds to certain viruses may trigger the disease. It is most probable that its development is triggered by a combination of genetic and environmental factors.
What is the best pain relief for polymyalgia?
Your doctor may recommend painkillers, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs), to help relieve your pain and stiffness while your dose of prednisolone is reduced.
What triggers polymyalgia?
The cause of polymyalgia rheumatica is unknown, but a combination of genetic and environmental factors is thought to be responsible. Polymyalgia rheumatica is an age-related condition. Most people diagnosed with it are over 70, and it’s very rare in people younger than 50. It’s also more common in women than men.
Is exercise good for polymyalgia?
If you have polymyalgia rheumatica, you’ll need to find the right balance between rest and activity. Too much exercise is likely to make your symptoms worse, but activity usually helps to ease pain and stiffness in the muscles of the shoulders, hips and thighs.
What happens when creatine kinase is elevated in polymyalgia?
Creatine kinase: This test is done to check for muscle tissue damage (myopathy), which can cause weakness and pain of the shoulder and hip muscles. If the level of creatine kinase in the blood is elevated, muscle damage is likely. In people with polymyalgia rheumatica, muscle damage is absent, so the creatine kinase level is normal.
Can a elevated CRP level indicate polymyalgia rheumatica?
An elevated CRP level in a patient with symptoms of polymyalgia rheumatica should increase suspicion of the condition. 6 However, a normal acute phase response does not rule out polymyalgia rheumatica.
When to know if you have polymyalgia rheumatica?
Polymyalgia rheumatica should be suspected in older patients with bilateral shoulder and hip stiffness that is worse in the morning and improves with use. An array of nonspecific musculoskeletal complaints, constitutional symptoms, and elevated serum inflammatory markers may be present, so other conditions should also be considered.
Is there a connection between polymyalgia rheumatica and giant cell arteritis?
The cause of polymyalgia rheumatica (PMR) is unknown. In addition to the frequent clinical association between PMR and giant cell (temporal) arteritis (GCA), there are pathogenic similarities (see “Pathogenesis of giant cell arteritis” ). Both PMR and GCA are associated with specific alleles of human leukocyte antigen (HLA)-DR4.