Die Thrombozytose bei Polymyalgia rheumatica
| Autor: | P. Harten, B. Seyfarth, H. Löffler |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty medicine.diagnostic_test Thrombocytosis business.industry Retrospective cohort study General Medicine medicine.disease Gastroenterology Polymyalgia rheumatica Pathognomonic Internal medicine Erythrocyte sedimentation rate medicine Platelet aggregation inhibitor Platelet Arteritis skin and connective tissue diseases business |
| Zdroj: | DMW - Deutsche Medizinische Wochenschrift. 121:1255-1260 |
| ISSN: | 1439-4413 0012-0472 |
| DOI: | 10.1055/s-2008-1043136 |
| Popis: | Basic problem and objective of study The diagnosis of polymyalgia rheumatica is made difficult by the absence of any pathognomonic findings. Erythrocyte sedimentation rate (ESR) and concentration of C-reactive protein are used as diagnostic criteria and to monitor the disease's course. It was the purpose of this study to evaluate prevalence of thrombocytosis and whether there is any correlation between thrombocytosis and ischaemic complications. Patients and methods In a retrospective study the data of 23 patients (14 women, 9 men; mean age 67.3 [48-84] years) with polymyalgia rheumatica were analysed: platelet counts, ESR and C-reactive protein had been measured at the time of diagnosis and 7, 14 and 21 days after start of glucocorticoid treatment. At the time of diagnosis 17 of 23 patients (74%) had a thrombocytosis (> 400,000/microliter), at a mean value of 511,000 (418,000-638,000)/microliter. The platelet count decreased more slowly than the inflammatory parameters. On average the platelet count returned to normal on the 14th day. Ischaemic complications developed in three patients (visual disturbances, blindness, cardiac arrhythmias, neurological deficits): all had a high platelet count (462,000-524,000/microliter). Conclusions Thrombocytosis can serve as an additional criterion in the diagnosis and follow-up of polymyalgia rheumatica. An association with ischaemic complications is especially likely in the elderly, in case of immobility and if there is evidence of giant-cell arteritis. Treatment with platelet aggregation inhibitors should be considered. |
| Databáze: | OpenAIRE |
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