[Myalgia of the girdle in the elderly: an uncommon etiology].

Abstract

We describe the clinical case of 80 years, caucasian woman, with personal history of osteoporosis and chronic normochromic normocytic anemia (NN). She had a three month history of myalgias of the girdle, stiffness in the morning, exceeding 1 hour, associated with inflammatory arthralgia of the small joints of hands and feet. Complementary exams showed normocytic normochromic anemia with Hg 9.8 g/dL; ESR 44 mm/h; CRP 7 mg/dL. Given the profile suggestive of Polymyalgia Rheumatica started prednisolone 10 mg/day with favorable clinical response. Four months after treatment she started paresthesias of right hand and foot, polaquiuria, petequial lesions in lower limbs and inability to walk; there was worsening of anemia and elevation of the biological parameters of inflammation, beginning of renal insufficiency with creatinine clearance 22 ml/min, proteinuria and eritrocituria. Renal biopsy was compatible with Wegener's granulomatosis/microscopic poliangeite. Vasculitis is a rare disease of the elderly and its clinical presentation is varied. The arteritis of giant cells and Polymyalgia Rheumatica are more common in the elderly. It is not often Polymyalgia-like presentation in cases of Wegener's granulomatosis/microscopic polyangitis.

• Authors: R Roque, A R Cravo, F Godinho, V Tavares, P Gonçalves, J Canas da Silva
• Journal: Acta reumatologica portuguesa (Acta Reumatol Port) 2010 Jan-Mar Vol. 35 Issue 1 Pg. 76-80 ISSN: 2184-8777 [Electronic] Portugal
• Vernacular Title: Mialgias das cinturas no idoso: uma etiologia pouco frequente.
• PMID: 20505632 (Publication Type: Case Reports, English Abstract, Journal Article)

Topics

• Aged, 80 and over
• Female
• Granulomatosis with Polyangiitis (complications)
• Humans
• Polymyalgia Rheumatica (etiology)