Were they ill first, i.e. could this be a "post viral" arth/myalgia in
which case a brief blast of steroid for a week might well switch them
off for good rather than needing prolonged rx?
? leave off the pred after a week and repeat bloods/rv for the
"youngster" especially
Srry this is evidence free meandering
On 16 March 2010 19:20, <[log in to unmask]> wrote:
> difficult...
> it's a common condition of course and it is seasonal
> 55 is quite young and if I see patients like that I look very hard for
> other possibilities, and raised ESR s aren't uncommon in poorly controlled
> diabetes
> Alk phos and leucocytes do go up in a marked inflammatory response, so it
> would be interesting to see how high the CRP particularly was in this
> patient (the first one).
> Of course most of the PMRs I see in secondary care are atypical in one way
> or another, which is why they are in secondary care, but you're right to
> query seeing several in a short period of time. If you were in Newcastle
> I'd come and have a look! Sorry if this isn't all that helpful.
> Lesley
>
>> Possibly one best fro Lesley Kay, but asking others here. I seem to have
>> had
>> an epidemic of PRs this last 5 weeks or so with around 5 patients who
>> clinically had PR, subsequently had markedly/moderately raised CRP & ESR
>> and
>> dramatic response to steroid treatment. Not typical amongst them was 2
>> youngish 55 year old male diabetics and one other patient with a polymorph
>> leucocytosis and raised Alkaline Phosphatase at presentation. In the later
>> the Alk Phos went down, but not the leucocyte count. I have referred her
>> to
>> rheumatology now and am awaiting the repsonse as to waht they think. My
>> problem is that I have just had a further patient - again with raised ESR
>> and markedly raised CRP, clinically Polymyalgia with again a raised Alk
>> Phos
>> and Polymorph leucocytosis. A saerch on the net shows that the raised Alk
>> Phos can occur in up to 30% but makes no mention of the Polymorph
>> leucocytosis, so my question is whether a leucocytosis is commonish in PR?
>>
>> --
>> Best Wishes
>>
>> Paul Bromley
>>
>> www.informatiks.com
>> Custom EMIS LV Software.
>> vuE | GPLabels | GPDocs | eGFRChecker
>>
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