Primary systemic amyloidosis presenting as giant cell arteritis and polymyalgia rheumatica

Abstract

Primary systemic amyloidosis may present with features suggesting a vasculitis, including giant cell arteritis (GCA) and polymyalgia rheumatica (PMR). In this report, we describe the clinical characteristics, temporal artery biopsy findings, and the response of vascular and musculoskeletal symptoms to corticosteroid therapy in 4 patients with primary systemic amyloidosis who presented with manifestations of GCA or PMR.

Primary amyloidoma of the axis and acute spinal cord compression: a case report

“…Salvarani et al have reported four cases of primary amyloidosis presenting with symptoms mimicking polymyalgia rheumatica, supporting the relationship between the two diseases. Because amyloidosis was primary and localized in our case, this association is probably coincidental [27].…”

Spondyloarthropathy presenting as a polymyalgia rheumatica-like syndrome

“…Although some diagnostic criteria have been proposed (10,11) they are not uniformly established and symptoms mimicking PMR can also be present in patients suffering from other conditions such as infections (like endocarditis (12) and Lyme borreliosis (13), malignancies (14), myelodysplastic syndromes (15)~ monoclonal gammopathies or multiple myeloma ( 16,17), hypothyroidism (18), vasculitis (19), systemic lupus erythematosus and other connective tissue diseases (20), crystal-induced arthritis (21), amyloidosis (22), toxic reactions to several drugs (23), and specially some types of seronegative rheumatoid arthritis in the elderly, whose limit with true PMR is controversial if it really exists (24).…”

Diagnosis and Treatment of Giant Cell Arteritis (Temporal Arteritis) – Past, Current and Future Aspects

“…Vasculitis of the temporal arteries has been reported in polyarteritis nodosa, Churg Strauss vasculitis, microscopic polyangiitis, Wegener`s granulomatosis, hepatitis B virus-related polyarteritis nodosa, hepatitis C virusrelated cryoglobulinemic vasculitis and rheumatoid vasculitis (29,240,241,242), but the clinical features of these diseases distinguish them from TA. Primary systemic amyloidosis may present with a clinical picture of either PMR or GCA or both (243). Malignancy and Cardiovascular disease in Giant cell arteritis.…”