Abstract:

Objective To compare the clinical manifestations of polymyalgia rheumatica (PMR) patients with different ages at diagnosis (>60 years and ≤60 years). Methods Sixty eight patients with PMR who were diagnosed and treated in our hospital from January 2013 to December 2019 were retrospective analyzed. The patients were divided into the PMR≤60 years old group (24 cases) and PMR>60 years old group (44 cases) based on different diagnosis age. The clinical data (general data, clinical features, laboratory indicators, treatment response) of two groups were compared. Results The differences in the course of disease and smoking between two groups weren’t statistically significant (P>0.05), and the proportion of women in the PMR>60 years old group was higher compared with that in the PMR≤60 years old group (P<0.05). The differences in the weight reduction, fever, shoulder girdle myalgia, pelvic girdle myalgia, neck pain, low back pain and morning stiffness weren’t statistically significant between groups (P>0.05); the difference in the level of lactate dehydrogenase (LDH) between groups wasn’t statistically significant (P>0.05). The level of the PMR>60 years old group had higher level of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and lower hemoglobin (Hb) level when compared with such indicators in the PMR≤60 years old group (P<0.05 at all points). All patients received the first-line glucocorticoid therapy, the differences in the proportion of glucocorticoids administered exclusively and cumulative doses of patients between two groups weren’t statistically significant (P>0.05). The proportion of recurrence in the PMR≤60 years old group was less when compared with that in the PMR≤60 years old group, (P<0.05). Conclusion Patients with the age at diagnosis ≤60 years old have a lower risk of recurrence compared with PMR patients with the age at diagnosis >60 years, and more aggressive glucocorticoid therapy is unreasonable.

Key words: polymyalgia rheumatica, age, glucocorticoids