Polymyalgia rheumatica in a married couple
Christoph Alexander Rüst,1 Beat Knechtle,1,2 Thomas Rosemann,1 Felix Wermelinger3
1Institute of General Practice and Health Services Research, University of Zurich, Zurich, Switzerland; 2St Gallen Health Center, St Gallen, Switzerland; 3Department of Rheumatology, University Hospital, University of Bern, Switzerland
Abstract: The case of a married couple developing polymyalgia rheumatica (PMR) consecutively is presented. The 55-year-old wife complained in June 2010 about pain in her neck. Case history, physical examination, and erythrocyte sedimentation rate (ESR) of 80 mm/hour led to the diagnosis of PMR. In May 2011, her 66-year old husband complained about pain in his neck, shoulders, buttocks, and thighs. Considering anamnesis, physical examination, and ESR of 56 mm/hour, the diagnosis of PMR was made. Both wife and husband responded to steroid treatment. When the steroid dose was gradually reduced, both patients relapsed. In order to lower the cumulative dose of glucocorticoid therapy, 10 mg methotrexate per week was added. In the literature, six cases of polymyalgia rheumatica in married couples have been described to date. In four cases, polymyalgia rheumatica occurred first in the wife. The interval of the diagnosis between the spouses ranged from 0 to 89 months. Although in most of the previous case reports a genetic disposition and an infectious agent have been discussed, this hypothesis must be questioned.
Keywords: husband, wife, erythrocyte sedimentation rate, C-reactive protein, polymyalgia rheumatica
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