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SHORT COMMUNICATION
Polymyalgia rheumatica with normal inflammatory indices at the time of diagnosis: can we just move a step forward?
1
Internal and Geriatric Medicine Department, Rheumatologic Outpatient Clinic Hospital “Mariano Lauro”, Sant’Angello, Italy
2
Department of Rheumatology, Internal Medicine, Geriatrics and Clinical Immunology, Pomeranian Medical University in Szczecin, Poland
Submission date: 2020-04-08
Acceptance date: 2020-05-04
Online publication date: 2020-06-29
Publication date: 2020-06-29
Reumatologia 2020;58(3):184-186
KEYWORDS
TOPICS
Cytokines, Inflammatory mediators and adaptive immunity in rheumatic diseasesVasculitis - aetiology, pathogenesis, clinical features and treatment
ABSTRACT
The existence of polymyalgia rheumatica (PMR) with normal inflammatory indices at the time of diagnosis still represents a diagnostic conundrum. According to the literature, some patients with PMR following immune checkpoint inhibitory therapy had normal values of both erythrocyte sedimentation rate and C-reactive protein concentrations at the time of diagnosis. In this short communication we investigated the possibility that in some patients with PMR the main pathogenic mechanism is constituted by inhibition of some checkpoints, such as programmed death receptor-1, programmed death ligand 1, and “cytotoxic” lymphocyte antigen 4. In these patients, the pathogenetic mechanisms underlying PMR can act much more upstream than commonly suggested. Also, we addressed the question of whether these patients should be considered as affected by PMR-like syndromes or by PMR subset.
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Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
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