Summary:
The author presents a review on polymyalgia rheumatica (PMR) and temporal arteriitis (TA).
Although the etiopathogenesis of the two diseases is not known, recently some evidence was
assembled on the possible participation of external factors, most probably infectious ones (e.g.
Chlamydia pneumoniae) or internal factors (genetic marker HLA-DRB1* 04). PMR and TA are close
syndromes which often occur concurrently. In both also some abnormalities were described which
suggest a profound immunological disorder. In the treatment of PMR and TA corticosteroids still
dominate. In PMR an initial dose of 15 mg prednisone is recommended (for the first month) with
a gradual change to maintenance doses of 5–7.5 mg within two months. The total period of treatment
should be about 2 years, in some patients with PMR it must be however 4–5 years. In TA the initial
doses of corticosteroids are higher. If the patient has visual symptoms we start with 40–80 mg
prednisone per day (an alternative is pulsed treatment) and in the absence of visual symptoms 20–40
mg/day. Treatment of PMR and TA involving large doses of corticosteroids for a relatively long time
is associated with the risk of osteoporosis. An initial DEXA examination and further monitoring is
therefore indicated. Preventively at least calcium plus vitamin D should be administered.
Key words:
polymyalgia rheumatica, temporal arteriitis, corticosteroids, osteoporosis
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