BACKGROUND: Polymyalgia rheumatica (PMR) may create some difficulties in the differential diagnosis of elderly-onset rheumatoid arthritis (EORA) and of EORA with PMR-like onset (EORA/PMR). AIM: To investigate possible differences between three groups of patients, with regard to serum levels of inflammatory cytokines and steroidal hormones at baseline and after 1 month of treatment with glucocorticoids (prednisone 7.5-12.5 mg/day). PATIENTS AND METHODS: 14 patients with PMR, 15 with EORA and 14 with EORA/PMR, as well as 15 healthy, matched controls were analysed. Tumour necrosis factor alpha (TNFalpha), interleukin (IL)6, IL1 receptor antagonist (IL1Ra), cortisol, dehydroepiandrosterone sulphate (DHEAS) and 17-hydroxy-progesterone (PRG) were evaluated. RESULTS: Serum levels of both TNFalpha and IL6 were significantly higher in all three groups of patients than in controls (p<0.01). Serum IL6 levels were significantly higher in patients with both PMR and EORA/PMR than in patients with EORA (p<0.05). IL1Ra serum levels were significantly higher in patients with EORA than in controls (p<0.001) and in patients with PMR and EORA/PMR (p<0.05). DHEAS was significantly lower in patients with EORA/PMR than in those with EORA (p<0.05). PRG was significantly higher in all patient groups (p<0.05). After glucocorticoid treatment, serum TNFalpha and IL6 levels significantly decreased in all patient groups; IL1Ra significantly increased in patients with PMR and in those with EORA/PMR; cortisol, DHEAS, and PRG significantly decreased in patients with PMR and in those with EORA/PMR (p<0.05). CONCLUSIONS: Different cytokine and steroidal hormone patterns suggest that patients with PMR and those with EORA/PMR seem to be have a more intensive inflammatory reaction and are more efficient responders to glucocorticoid treatment than patients with EORA.
BACKGROUND:Polymyalgia rheumatica (PMR) may create some difficulties in the differential diagnosis of elderly-onset rheumatoid arthritis (EORA) and of EORA with PMR-like onset (EORA/PMR). AIM: To investigate possible differences between three groups of patients, with regard to serum levels of inflammatory cytokines and steroidal hormones at baseline and after 1 month of treatment with glucocorticoids (prednisone 7.5-12.5 mg/day). PATIENTS AND METHODS: 14 patients with PMR, 15 with EORA and 14 with EORA/PMR, as well as 15 healthy, matched controls were analysed. Tumour necrosis factor alpha (TNFalpha), interleukin (IL)6, IL1 receptor antagonist (IL1Ra), cortisol, dehydroepiandrosterone sulphate (DHEAS) and 17-hydroxy-progesterone (PRG) were evaluated. RESULTS: Serum levels of both TNFalpha and IL6 were significantly higher in all three groups of patients than in controls (p<0.01). Serum IL6 levels were significantly higher in patients with both PMR and EORA/PMR than in patients with EORA (p<0.05). IL1Ra serum levels were significantly higher in patients with EORA than in controls (p<0.001) and in patients with PMR and EORA/PMR (p<0.05). DHEAS was significantly lower in patients with EORA/PMR than in those with EORA (p<0.05). PRG was significantly higher in all patient groups (p<0.05). After glucocorticoid treatment, serum TNFalpha and IL6 levels significantly decreased in all patient groups; IL1Ra significantly increased in patients with PMR and in those with EORA/PMR; cortisol, DHEAS, and PRG significantly decreased in patients with PMR and in those with EORA/PMR (p<0.05). CONCLUSIONS: Different cytokine and steroidal hormone patterns suggest that patients with PMR and those with EORA/PMR seem to be have a more intensive inflammatory reaction and are more efficient responders to glucocorticoid treatment than patients with EORA.
Authors: L Boiardi; C Salvarani; J M Timms; T Silvestri; P L Macchioni; F S di Giovine Journal: Clin Exp Rheumatol Date: 2000 Nov-Dec Impact factor: 4.473
Authors: M Cutolo; B Villaggio; L Foppiani; M Briata; A Sulli; C Pizzorni; F Faelli; C Prete; L Felli; B Seriolo; M Giusti Journal: Ann N Y Acad Sci Date: 2000 Impact factor: 5.691
Authors: C Salvarani; B Casali; L Boiardi; A Ranzi; P Macchioni; D Nicoli; E Farnetti; M Brini; I Portioli Journal: J Rheumatol Date: 2000-05 Impact factor: 4.666
Authors: Maurizio Cutolo; Rainer H Straub; Luca Foppiani; Camilla Prete; Lia Pulsatelli; Alberto Sulli; Luigi Boiardi; Pierluigi Macchioni; Massimo Giusti; Carmen Pizzorni; Bruno Seriolo; Carlo Salvarani Journal: J Rheumatol Date: 2002-04 Impact factor: 4.666
Authors: R H Straub; T Glück; M Cutolo; J Georgi; K Helmke; J Schölmerich; P Vaith; B Lang Journal: Rheumatology (Oxford) Date: 2000-06 Impact factor: 7.580
Authors: J Narváez; J M Nolla-Solé; J A Narváez; M T Clavaguera; J Valverde-García; D Roig-Escofet Journal: Ann Rheum Dis Date: 2001-11 Impact factor: 19.103
Authors: Elizabeth W Karlson; Lori B Chibnik; Shelley S Tworoger; I-Min Lee; Julie E Buring; Nancy A Shadick; Joann E Manson; Karen H Costenbader Journal: Arthritis Rheum Date: 2009-03