Reumatizam, Vol. 65 No. suppl.1, 2018.
Prethodno priopćenje
THE OCCURRENCE OF PARANEOPLASTIC SYNDROMES IN PATIENTS WITH POLYMYALGIA RHEUMATICA TREATED AT THE UNIVERSITY HOSPITAL CENTER OSIJEK
Ana Marija Lukinac
orcid.org/0000-0001-6687-8500
; Department of Rheumatology, Clinical Immunology and Allergology, University Hospital Center Osijek, Croatia
Željka Kardum
; Department of Rheumatology, Clinical Immunology and Allergology, University Hospital Center Osijek, Croatia
Ivana Kovačević
; Department of Rheumatology, Clinical Immunology and Allergology, University Hospital Center Osijek, Croatia
Jasminka Milas-Ahic
; Department of Rheumatology, Clinical Immunology and Allergology, University Hospital Center Osijek, Croatia
Višnja Prus
; Department of Rheumatology, Clinical Immunology and Allergology, University Hospital Center Osijek, Croatia
Sažetak
Background: Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease that occurs in an elderly person, usually over fifty years of age. Disease is characterized by pain, discomfort, and tenderness of shoulder, throat and hip muscles, elevated erythrocyte sedimentation values, and a fast and effective therapeutic response to the applied glucocorticoid therapy. Clinical image of PMR may resemble the presentation of many malignant diseases, given that it is of great importance to do extensive diagnostic treatment of the patient.
Objectives: Th e aim of this study was to investigate the occurrence of paraneoplastic syndromes in patients with PMR, treated at the Department of Rheumatology, Clinical Immunology and Allergology of the University Hospital Center of Osijek (UHCO).
Methods: Th e study included PMR patients treated at the UHCO in the period from 1/2013. to 10/2018. A study was conducted using data from the General Practice Research Database of the UHCO.
Results: In 46 patients with PMR the occurrence of paraneoplastic syndrome was 8.7% (N=4) with a 95% confidence interval of 2.42%–20.79%. Th e median age of the detection of the paraneoplastic syndrome was 73 (65–85) years, and the mean time of detection of the syndrome since the diagnosis of PMR was 1± 1 years. In total number
of diagnosed, there is an equal number of male and female patients (N=2, p>0.999). Among males, the occurrence of paraneoplastic syndrome was 15.38%, and among women 6.02% (p = 0.585). The mean age of discovery of male paraneoplastic syndrome was 75±14.14, and in women 64±7.07 godina (p=0.699). Th ere was no statistically significant difference in the age of PMR patients (76.17±6.93) compared to those with paraneoplastic syndrome (71.5±9.11), p=0.213.
Conclusions: According to the results of our research the time to diagnose paraneoplastic syndrome is approximately one year after the diagnosis of PMR. Therefore, more extensive diagnostic processing and disease control during the first year from the diagnosis of the PMR will reduce the risk of non-recognition of malignant disease disguised as a clinical image of PMR. In addition, the occurrence of paraneoplastic syndromes was 8.7% in the population of PMR patients included in this fi ve-year study.
References:
1. Muller, Sara, et al. Is cancer associated with polymyalgia rheumatica? A cohort study in the General Practice Research Database. Ann
Rheum Dis. 2014;73(10): 1769–73.
2. Muller, S., et al. Th e real evidence for polymyalgia rheumatica as a paraneoplastic syndrome. Reumatismo. 2018; 70(1): 23–34.
3. Ji, Jianguang, et al. Cancer risk in patients hospitalized with polymyalgia rheumatica and giant cell arteritis: a follow-up study in
Sweden. Rheumatology.2010; 49(6): 1158–63.
4. Myklebust, Geirmund, et al. No increased frequency of malignant neoplasms in polymyalgia rheumatica and temporal arteritis. A
prospective longitudinal study of 398 cases and matched population controls. J Rheum.2002; 29(10): 2143–7.
5. Mayer, Miroslav, and Branimir Anić. Paraneoplastički sindromi u reumatologiji. Reumatizam.2015; 62(Suppl. 1): 0–0.
Ključne riječi
Polymyalgia rheumatica; Paraneoplastic syndromes; Occurrence
Hrčak ID:
216015
URI
Datum izdavanja:
5.12.2018.
Posjeta: 754 *