[3 cases of polymyalgia rheumatica (PMR), in which serum amyloid A was a useful index of the disease activity].
Yamane T , Yamauchi H , Imaizumi Y , Senba T
We encountered 3 cases of polymyalgia rheumatica (PMR), in which serum amyloid A (SAA) levels were correlated with clinical pictures after normalization of ESR and CRP levels. Therefore, it is suggested that SAA may be a useful index for evaluating the severity of intractable PMR. Case 1: The patient was a 75-year-old man. Although ESR and CRP levels were normalized after the administration of PSL (20 mg/day), myalgia persisted. When the dose of PSL was reduced, PMR recurred, which was relieved by administering 15 mg/day of PSL. However, myalgia recurred again when the dose of PSL was reduced thereafter. The elevated SAA level (33.0 micrograms/ml) was normalized by continuous administration of PSL without reducing the dose, resulting in the relief of myalgia. Case 2: The patient was a 65-year-old woman. The administration of PSL was initiated at a dose of 15 mg/day. Although myalgia was relieved, the symptom and elevated SAA levels persisted for approximately 3 months. Thereafter, PMR recurred, and SAA levels were markedly increased to 78.2 micrograms/ml. However, the symptom of PMR was eliminated by continuously administering PSL without reducing the dose. Although the dose of PSL was then reduced after the decrease in SAA levels, PMR did not recur. Case 3: The patient was an 88-year-old woman. Although the symptom of PMR was relieved by administering 15 mg/day of PSL, myalgia persisted. Since SAA levels were increased to 106 micrograms/ml, PSL was continuously administered without reducing the dose, resulting in the disappearance of the symptom and normalization of SAA levels approximately 3 months later. Although the dose of PSL was then reduced to 12.5 mg/day, PMR did not recur.
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