臨床検査62巻6号

2018年06月発行

今月の特集2 筋疾患に迫る

リウマチ性多発筋痛症

著者： 土橋浩章¹

所属機関： ¹香川大学医学部・医学系研究科内科学講座血液・免疫・呼吸器内科学

ページ範囲：P.740 - P.746

Point

●リウマチ性多発筋痛症（PMR）は多彩な臨床像を呈するが，特異的なバイオマーカーは認められない．

●関節超音波はPMRの診断に有用な補助ツールである．

●ステロイド投与で速やかに改善を認めるが，減量は緩徐に行う必要がある．

参考文献

1）Okumura T, Tanno S, Ohhira M, et al：The rate of polymyalgia rheumatica (PMR) and remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a clinic where primary care physicians are working in Japan. Rheumatol Int　32：1695-1699，2012

2）伊藤聡：リウマチ性多発筋痛症．リウマチ病学テキスト（一般社団法人日本リウマチ学会生涯教育委員会，財団法人日本リウマチ財団教育研修委員会編），診断と治療社，pp148-150，2010

3）Bird HA, Esselinckx W, Dixon AS, et al：An evaluation of criteria for polymyalgia rheumatica. Ann Rheum Dis　38：434-439，1979

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12）Dejaco C, Singh YP, Perel P, et al：2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis　74：1799-1807，2015

13）Dejaco C, Singh YP, Perel P, et al：Current evidence for therapeutic interventions and prognostic factors in polymyalgia rheumatica: a systematic literature review informing the 2015 European League Against Rheumatism/American College of Rheumatology recommendations for the management of polymyalgia rheumatica. Ann Rheum Dis　74：1808-1817，2015

14）Kremers HM, Reinalda MS, Crowson CS, et al：Relapse in a population based cohort of patients with polymyalgia rheumatica. J Rheumatol　32：65-73，2005

15）De Silva M, Hazleman BL：Azathioprine in giant cell arteritis/polymyalgia rheumatica: a double-blind study. Ann Rheum Dis　45：136-138，1986

16）Catanoso MG, Macchioni P, Boiardi L, et al：Treatment of refractory polymyalgia rheumatica with etanercept: an open pilot study. Arthritis Rheum　57：1514-1519，2007

17）Hagihara K, Kawase I, Tanaka T, et al：Tocilizumab ameliorates clinical symptoms in polymyalgia rheumatica. J Rheumatol　37：1075-1076，2010