Publication: 21. Yüzyılda polimyaljiya romatika
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Date
2012
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Abstract
Polimyaljiya romatika (PMR), ileri yaş grubunda omuz ve pelvik kuşak ağrısı ve sabah tutukluğu ile karakterize inflamatuvar bir hastalıktır. Hastalığın etiyopatogenezi tam olarak bilinmemekle birlikte genetik ve çevresel faktörler suçlanmaktadır. Tanı için özgül bir test bulunmamakta, görüntüleme yöntemlerindeki gelişmelere rağmen tanı klinik bulgulara dayanmaktadır. Tedavisinde steroidler başlıca kullanılan ilaçlardır, hatta steroide verilen dramatik yanıt tanı kriteri olarak kullanılmıştır. Buna karşın steroidin başlangıç dozu, kullanım süresi, doz azaltılması konularında optimal bir yaklaşım söz konusu değildir. Dahası steroid tedavisi altında relapslar izlenebilmektedir. Steroidlerin etkisiz olduğu durumlarda veya steroidler kesilmek istendiğinde metotreksat kullanılabilmektedir. Son yıllarda biyolojik ajanların kullanılması ile ilgili deneyim artmaktadır.
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease of elderly, characterised by pain and morning stiffness of the shoulder and pelvic girdle. Although the ethiopathogenesis of PMR is unknown, environmental and genetic factors are suspected. Despite the progress in imaging techniques achieved in recent years, there is no speific diagnostic test and the diagnosis is generally based on clinical features. The steroids are the main therapy for PRM. Thus, the dramatic response to steroid therapy has been used as a diagnostic criterion. However, there is lack of optimal intervention regarding initial dose, usage period and dose reduction. Moreover, relapses can be seen during the steroid therapy. Methotrexate can be used in case of unresponsiveness to steroids or aim to reduce daily steroid dose. The experiences about using biologic agents are increasing in recent years.
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease of elderly, characterised by pain and morning stiffness of the shoulder and pelvic girdle. Although the ethiopathogenesis of PMR is unknown, environmental and genetic factors are suspected. Despite the progress in imaging techniques achieved in recent years, there is no speific diagnostic test and the diagnosis is generally based on clinical features. The steroids are the main therapy for PRM. Thus, the dramatic response to steroid therapy has been used as a diagnostic criterion. However, there is lack of optimal intervention regarding initial dose, usage period and dose reduction. Moreover, relapses can be seen during the steroid therapy. Methotrexate can be used in case of unresponsiveness to steroids or aim to reduce daily steroid dose. The experiences about using biologic agents are increasing in recent years.
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Rehabilitasyon