PMR Flair up From a Virus?

Hello @dougschiffman, It's never fun having a flare up with your PMR. You will notice that we merged your discussion with an existing discussion on the same topic so that you meet other members like @christopherc, @priscillat, @aspine and others with PMR who have experienced with flair ups from a virus or flu. If you click the link below it will take you to the beginning of the discussion.
--- PMR Flair up From a Virus?: https://connect.mayoclinic.org/discussion/flair-up-from-a-virus/.

Have you tried slightly upping the dose of prednisone to see if that helps?

Your 7 mg dose does make a difference when you get an infection and are sick. You are at the stage where you are potentially at risk of adrenal insufficiency. "Sick day rules" are more for people diagnosed with adrenal insufficiency. People with PMR who are on long term prednisone are at risk of adrenal sufficiency but that doesn't mean everyone with PMR should be following sick day rules.
https://www.endocrinology.org/media/4169/ai-and-exogenous-steroids_patient-information-sheet.pdf
Please don't increase your dose based solely on these "sick day rules." Without knowing your entire medical history, nobody should be advising you to follow sick day rules. Please discuss this with your doctor.

When a person is sick, the body needs more cortisol. More prednisone might be helpful but informing your doctor is extremely important.

This appeared to happen with my dad. He had an unspecified respiratory infection that required antibiotics and now it’s 5 weeks later, and his rheumatologist suspects a PMR flare. He was currently at 5 mg prednisone, and she increased him to 6 mg.

It doesn’t seem too out of the ordinary for this to happen because viral infections are known to trigger immune or autoimmune conditions, even if we don’t quite know how or why this happens?

@christopherc topherc Interesting question I had covid in the last year or so now I have PMR Id be interested in finding out also . Haven't seen my rheumatologist yet but will ask him

An autoimmune disorder that I am diagnosed with is called "reactive arthritis." The name is derived from a "reaction to an infection." Whenever I have certain types of infections, the "flare reaction" happens. A viral infection can cause a flare of reactive arthritis but it seems to depend on the type of virus.
https://www.mayoclinic.org/diseases-conditions/reactive-arthritis/symptoms-causes/syc-20354838
Sometimes I'm prescribed antibiotics with the hope that the antibiotic will help my pain. I can't say antibiotics ever helped but prednisone would stop the pain. Reactive arthritis responds to prednisone the same way PMR responds to prednisone. However, reactive arthritis isn't usually treated with long term prednisone.

I was told when I was first diagnosed that flares of reactive arthritis could happen in the following ways:

#1 It might only happen once and go away completely.
#2 It could start recurring.
#3 It could become chronic

From my experience with reactive arthritis ... It did all three.

Reactive arthritis is usually diagnosed at a younger age than PMR. Unfortunately, being diagnosed with reactive arthritis doesn't exempt you from being diagnosed with PMR when you are older.

Yes, I read that PMR has the highest rate in Norway and other parts of Scandinavia so that points to a genetic susceptibility. I then did a DNA test with ancestry.com and found that I have Norwegian, Danish and Swedish DNA. Not the majority but they also do a chromosome painter that shows where each origin sits. I can’t yet decipher the chromosome map but given I have 17% of my DNA from Scandinavia and the fact my mother had PMR too, makes me think that all I needed was a trigger. I still don’t know if it was vaccinations - I had the Zoster, COVID booster and flu - in the previous two weeks. I rarely get sick so I have a strong immune system already and the vaccines could have tipped me over the top. When I was a child my mother got tuberculosis and each year they did a Mantoux test on me. The idea was to get a positive reaction. After three years I didn’t and they said it was likely I would never get TB yet my father and brother Had positive responses. I react quite alarmingly to bites from insects. Sorry for the rave but I’m trying to understand immune responses - environmental and genetic. I hope my daughter doesn’t get this as she has inherited the 5% Norwegian but none of the other DNA, which came from my fathers side. FYI photo of part of the story

2020, I had a PMR Dx, my grandmother (100% Swedish) had symptoms of PMR, although no diagnosis as far as I know.

I am 51% Swedish in genetic studies and I followed the profile of onset being at 70 years of age, w/o any other joint issues before the onset of PMR. My diagnosis came after a very stressful event.

Best of luck to all and keep researching for the best care. When I was at my worst this website gave me hope and leadership, it had a positive influence on my recovery.

Thanks all. This dialogue is interesting and helpful. I am on another network with a lot of individuals from the UK. It appears the English/Scottish background is well represented in the PMR distribution also. While I am in the US, I have the Scottish background. Heredity appears to be a factor for sure.

I had what I believe was a flare from the covid vaccine. I got the vaccine on Monday, and by Friday I tested positive for covid. I have never been so sick in my life. I could not move because it hurt so badly. I could not even lift my arms. My legs hurt so much, I had to have assistance to the bathroom. It was horrible!

Scandinavian heritage is well represented too.

I wonder why these ethnic groups are more susceptible?