Tuberculosis masquerading as polymyalgia rheumatica
Tóm tắt
Polymyalgia rheumatica (PMR) is a connective tissue disorder of unknown aetiology. It is hypothesized that, in a genetically predisposed person, its pathogenesis is triggered by an environmental factor, possibly a hitherto unknown infectious agent. We present the case of a 68-year-old woman who is being treated for PMR. She developed tubercular lymphadenitis and erythema nodosum and improved with antitubercular treatment. We hypothesize that the trigger for pathogenesis of PMR in this lady was antigen of Mycobacterium tuberculosis.
Tài liệu tham khảo
Gonzalez-Gay MA, Vazquez-Rodriguez TR, Lopez-Diaz MJ, Miranda-Filloy JA, Gonzalez-Juanatey C, Martin J, et al. Epidemiology of giant cell arteritis and polymyalgia rheumatica. Arthritis Rheum 2009; 61:1454– 1461.
Langford CA. The vasculitis syndromes. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J ed. Harrison’s principles of internal medicine. 18th ed. NY, USA: Mc Graw Hill; 2012. 2:2785–2801.
Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet 2008; 372:234–245.
Martinez-Taboada VM, Alvarez L, RuizSoto M, Marin-Vidalled MJ, Lopez-Hoyos M. Giant cell arteritis and polymyalgia rheumatica: role of cytokines in the pathogenesis and implications for treatment. Cytokine 2008; 44:207–220.
Gonzalez-Gay MA, Garcia-Porrua C, Miranda-Filloy JA, Martin J. Giant cell arteritis and polymyalgia rheumatica: pathophysiology and management. Drugs Aging 2006; 23:627–649.
Blockmans D. PET in vasculitis. Ann N Y Acad Sci 2011; 1228:64–70.
Dasgupta B, Cimmino MA, Maradit-Kremers H, Schmidt WA, Schirmer M, Salvarani C, et al. 2012 provisional classification criteria for polymyalgia rheumatica: a European League against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2012; 71:484–492.
Harrington JT. Mycobacterial and fungal infections. In: HarrisJr ED, Budd RC, Genovese MC, Firestein GS, Sargent JS, Sledge CB, Ruddy S ed. Kelly’s textbook of rheumatology. 7th ed. Philadelphia, PA: Elsevier Saunders; 2001; 1646–1660.
Wollheim FA. Enteropathic arthritis. In “Kelley WN, Shaun R, Harris ED, Sledge CB. Kelley’s textbook of Rheumatology, 6th edition, Philadelphia, WB Saunders Company, 2001; 1081–1088.
American Thoracic Society. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Recomm Rep 2000; 49:1–51.