Abstract
Zusammenfassung. Die Polymyalgia rheumatica (PMR) ist ein häufiges inflammatorisches Syndrom, welches zusammen mit einer Riesenzellarteriitis (RZA) auftreten kann. Die besondere Schwierigkeit besteht bei der PMR oft in der Diagnosestellung bei nur unspezifischen Symptomen und vielen Differenzialdiagnosen. Der Ultraschall, aber auch weitere bildgebende Verfahren haben die Diagnostik für PMR und RZA deutlich verbessert und beschleunigt, sodass Komplikationen wie Erblindung reduziert werden können. Glukokortikoide spielen immer noch eine wichtige Rolle bei der Primärtherapie beider Erkrankungen. Obwohl hinsichtlich der Prävention von und des Screenings auf Langzeitkomplikationen bei RZA weitere Forschung notwendig ist, hat der effektive Einsatz von Biologika wie Tocilizumab die Behandlungsmöglichkeiten der RZA deutlich erweitert und erlaubt eine Reduktion von Nebenwirkungen.
Abstract. Polymyalgia rheumatica (PMR) is an inflammatory syndrome which often co-incides with giant cell arteritis (GCA). Due to unspecific symptoms and a plethora of possible alternative diagnoses, PMR often represents a diagnostic challenge. The use of ultrasound, but also other imaging methods has improved and accelerated the time to diagnosis in PMR and GCA, so that complications such as blindness can be reduced. Glucocorticoids are still the main initial therapy for both diseases. Although further research is needed concerning prevention of and screening for long term complications for GCA, the efficacy of biologicals, namely tocilizumab, has markedly increased therapeutic options for GCA and allows for a reduction of side effects.
Résumé. La polymyalgie rhumatismale (PMR) est un syndrome inflammatoire courant qui peut se produire en même temps que l’artérite à cellules géantes (RZA). La difficulté particulière de la RPM est souvent le diagnostic de symptômes non spécifiques et de nombreux diagnostics différentiels. Les ultrasons, mais aussi d’autres techniques d’imagerie, ont considérablement amélioré et accéléré le diagnostic de la PMR et de la RZA, de sorte que des complications telles que la cécité peuvent être réduites. Les glucocorticoïdes jouent toujours un rôle important dans la thérapie primaire de ces deux maladies. Bien que des recherches supplémentaires soient nécessaires sur la prévention et le dépistage des complications à long terme du RZA, l’utilisation efficace de produits biologiques tels que le tocilizumab a considérablement élargi les options de traitement et permet de réduire les effets secondaires.
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