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Pol Merkur Lekarski. 2015 Mar;38(225):164-5.

Polymyalgia rheumatica in a patient with splenic marginal zone lymphoma - a case report.

Author information

1
Military Institute of Medicine, Warszawa, Poland: Department of Internal Diseases and Rheumatology.
2
Military Institute of Medicine, Warszawa, Poland: Department of Internal Diseases and Hematology.

Abstract

Polymyalgia rheumatica (PMR) is a common inflammatory disease in elderly people. We present a case of a 49-year-old woman diagnosed with PMR. The treatment with prednisone resulted in a rapid resolution of clinical symptoms. However, inflammatory markers remained elevated. Ultrasonography and computed tomography revealed the presence of a large splenic lesion. A cyst was suspected but, because of the high risk of splenic rupture, a splenectomy was performed. The histopathological examination revealed the presence of splenic marginal zone lymphoma. Inflammatory markers returned to normal after splenectomy. Prednisone was tapered but clinical symptoms of PMR reappeared after lowering the dose of prednisone <10 mg/day. Thus, treatment with methotrexate was started, which allowed for further tapering of prednisone.

KEYWORDS:

glucocorticoids; methotrexate; polymyalgia rheumatica; splenic marginal zone lymphoma

PMID:
25815618
[Indexed for MEDLINE]

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