Transcription of 意外と多いリウマチ性多発筋痛症 - hakatara.net
1 1 (Polymyalgia rheumatica:PMR) 2012 EULAR/ACR Provisional Classification Criteria for Polymyalgia Rheumatica 50 10 50 65 70 1 PMR 16 40 PMR HLA DRB*0401 DRB*0404 2
2 IL-6 ADL 1 2 ADL 3 ROM 3 ( 1) ( CRP ) CCP ALP RA MMP-3 4 2 EULAR/ACR 5 3 6 7 EULAR/ACR ECHO RA RA 2 3 3 / / / / / / PMR RS3PE SLE Parkinson 50 X
3 X ESR/CRP (PTH D) Dasgupta B,et (Oxford)2010;49:186-190 1 4 4 US 6 PMR US 8 6 PMR Dasgupta8 PMR ( 1 4) elderly onset RA RF CCP PMR Caporali9 RA PMR 94 1 19 RA PMR 64 6 RA PMR 10 PMR RA RS3PE RA,PMR RS3PE 11 5 Differential diagnosis in patients presenting with a polymyalgia-like illenessRheumatologicaladiseases Polymyalgiarheumatica Rheumatoid arthritis Spondyroarthropathy Crystalline arthritis(calcium pyrophosphate disease and calcium hydroxyapatitedisorders)
4 Remitting Seronegativesymmetric synovitiswith pitting oedemasyndrome Connective tissue disease Vasculitis(giant arteritis,antineutrophilcytoplasmicantib ody-associated vasculitis) Inflammatory myopathies(dermatomyositis,polymyositis) Non-inflammatory musculoskeretaldisorders Rotator-cuff disease Adhesive capsulitis Degenerative joint disease FibromyalgiaEndocrinopathies Thyroid diseases Diordersof the parathyroid glandInfections Viral Bacterial sepsis,endocarditis,discspace infection,septicarthritis Mycobacterial-eg,tuberculosisMalignant diseases Solid, hematologicalMiscellaneous disorders Parkinsonism Depression HypovitaminosisD Drug-induced myopathies-eg, from statins5 2 6 3 5 HermandezR J.
5 Treatment of PMR: A systematic Review. Arch Intern Med. 2009;1691839-18507 PSL 10mg/D 15 20mg/D ( 2) 3 2009 12 PMR 20mg/D 30mg/D 20mg/D 20mg/D 2 2mg 6 off 2 5 off 1 Chuang TY, Hunder GG, Ilstrup DM, Kurland LT. Polymyalgia rheumatica: a 10-year epidemiologic and clinical study. Ann Intern Med 1982; 97: 672-80. 2 Haworth S, Ridgeway J, Stewart I, et al. Polymyalgia rheumatic is associated with both HLA-DRB*0401 and DRB*0404. Br J Rheumatol 1996;35:632. 3.
6 2010; 99 (10): 84-89. 4 32:274-278,2009. 5 Dasgupta B, Cimmino MA, Kremers HM, et al. 2012 Provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis Rheum 2012; 64: 943-54. 6 Nobunaga M, Yoshioka K, Yasuda M, Shingu M. Clinical studies of polymyalgia rheumatica: a proposal of diagnostic criteria. Jpn J Med 1989; 28: 452-6. 7 Nishioka J, Shichikawa K, Nakai H, et al. Symptomatological study of polymyalgia rheumatics in japan-induction of diagnostic criteria for Japanese patients. Ryumachi 1985; 25: 265. 8 Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of polymyalgia rheumatica.
7 Rheumatology (Oxford) 2010; 49: 186. 9 Caporali R, Montecucco C, Epis O, et al. Presenting of polymyalgia rheunatica and rheumatoid arthritis with PMR-like onset: a prospective study. Ann Rheum Dis 2001; 60: 1021. 10 RA 47(4):328-333, 2012 11 Russel EB, et al: Remitting, seronegative, symmetrical synovitis with pitting edema-13 additional case. J Rheumatol 17: 633-639, 1990 12 Hermandez Rodriguez J, Cid MC, Lopez-Soto A, et al. Treatment of Polymyalgia Rheumatica: A systematic Review. Arch Intern Med 2009;169:1839-1850
