Klinische Charakteristika und Laborbefunde von Polymyalgia rheumatica (PMR) und Riesenzellarteriitis (RZA)

Zusammenfassung

Die PMR ist überwiegend eine klinische Diagnose: Stammnahe Muskelschmerzen bei älteren Patienten, die häufig rasch progredient einsetzen, eine ausgeprägte Morgensteifigkeit, sowie das überzeugende Ansprechen auf eine Steroidtherapie lassen oft wenig Zweifel an der Diagnose.

Die Manifestationen der RZA können variabler sein und werden vom betroffenen Gefäßgebiet beeinflusst. Die AT geht in mehr als zwei Dritteln der Fälle mit Kopfschmerzen einher, diagnostisch richtungsweisend können Schmerzen beim Kauen sein, die sog. Kiefer-Claudicatio. Die schmerzhaft verdickte Schläfenarterie ist ein klassisches Merkmal des Krankheitsbildes.

Für PMR und AT gibt es keine richtungsweisenden Laborbefunde. Erhöhte Entzündungswerte sind bei beiden Entitäten die Regel, zu der es nur wenige Ausnahmen gibt.

Abstract

The diagnosis of polymyalgia rheumatica can often be made based on symptoms and signs only. Aching muscle pain in the shoulder girdle, gluteal region and thighs may occur with a rapid onset, accompanied by lasting morning stiffness. The immediate pain relief after the initiation of the treatment with corticosteroids is a helpful diagnostic sign as well.

The clinical image of giant cell arteritis is more variable and depends on the vascular region affected by the inflammatory process. Headache is a typical sign of temporal arteritis, as well as jaw claudication. A prominent, painful temporal artery is a classical sign.

There are no pathognomonic laboratory abnormalities for both polymyalgia rheumatica and temporal arteritis. Both are accompanied by elevated acute phase reactants, although few exceptions exist to this rule.

Schlüsselwörter

Polymyalgia rheumatica - Arteriitis temporalis - Riesenzellarteriitis - Laborbefunde

Key words

polymyalgia rheumatica - temporal arteritis - giant cell arteritis - laboratory values

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