Serum Amyloid A as a Potent Therapeutic Marker in a Refractory Patient with Polymyalgia Rheumatica

Yasuhiro SHIMOJIMA; Masayuki MATSUDA; Takahisa GONO; Wataru ISHII; Shu-ichi IKEDA

doi:10.2169/internalmedicine.44.1009

CASE REPORTS

Serum Amyloid A as a Potent Therapeutic Marker in a Refractory Patient with Polymyalgia Rheumatica

Yasuhiro SHIMOJIMA, Masayuki MATSUDA, Takahisa GONO, Wataru ISHII, Shu-ichi IKEDA

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Keywords: C-reactive protein, erythrocyte sedimentation rate, flow cytometry, polymyalgia rheumatica, remitting seronegative symmetrical synovitis with pitting edema, serum amyloid A

JOURNAL OPEN ACCESS

2005 Volume 44 Issue 9 Pages 1009-1012

DOI https://doi.org/10.2169/internalmedicine.44.1009

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Abstract

We report a patient with polymyalgia rheumatica (PMR) who showed a relapse soon after tapering of oral prednisolone. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were quickly normalized after the re-increase in oral prednisolone, and muscle pain and stiffness gradually improved in parallel with a decrease in serum amyloid A (SAA). Flow cytometry simultaneously demonstrated an increase in CD8⁺CD25⁺ cells and a decrease in CD4⁺CD25⁺ cells and CD4⁺CD45RA⁺ cells. When clinical symptoms remain with negative results for CRP and ESR even after the start of corticosteroid treatment, SAA might be a potent therapeutic marker for disease activity in PMR.

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