Cause of PMR
https://med.stanford.edu/news/all-news/2024/02/women-autoimmune.html
This article isn't light reading but goes into why women are more likely to have autoimmune diseases than men. Bottom line - it's thanks to our 2 X chromosomes. If you skip down to the bottom of the article, they say the discovery could lead to better screening for autoimmune disorders that are associated with the Xist gene that they explain in the article.
Interested in more discussions like this? Go to the Polymyalgia Rheumatica (PMR) Support Group.
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I believe PMR has an inherited component in some people. Judging by the symptoms, I would say my mother had it at about the age I had it, got some prednisone, and then lived to 101 with no more symptoms and as many faculties as a few small strokes near the end allowed. It struck at a very stressful time in her life and they called it bursitis. I also believe my grandmother had it at a young age during a stressful time in her life. They didn't have prednisone then and she suffered the rest of her life, also perhaps getting GCA according to her symptoms. At that time they didn't know they could be related. My mother and I were healthy and active otherwise. I have had all the covid shots and boosters with no ill effects. I also had covid once last year, but Paxlovid knocked it out pretty quickly.
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2 Reactions@jiffaw Plastics (endocrine disruptors) and industrial and agricultural pollution, including PFAs.
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2 ReactionsI realize that PMR has, currently, no known single cause. I used AI (Perplexity) to answer the questions, "What causes PMR?" Here is what it said.
Polymyalgia rheumatica (PMR) does not have a single known cause; current evidence points to a mix of genetic susceptibility, aging of the immune system, and environmental triggers such as infections or (more rarely) vaccines and other inflammatory stressors. It is best understood as an immune‑mediated inflammatory disorder rather than something caused by muscle overuse or a mechanical problem.
What is known vs unknown
Experts agree that the exact cause of PMR is unknown, so there is no single confirmed trigger that explains all cases. PMR is thought to arise when an aging immune system becomes dysregulated in genetically susceptible people, leading to inflammation around shoulders, hips, and other proximal structures.
Genetic and age factors
Family clustering and specific immune‑related genes (such as certain HLA class II types, especially HLA‑DRB1*04) suggest a genetic predisposition to PMR. The condition occurs almost exclusively in people over 50, with peak onset in the 70s, indicating that age‑related immune and hormonal changes contribute substantially.
Immune and autoimmune mechanisms
PMR is an immune‑mediated inflammatory disease where cytokines such as interleukin‑6 (IL‑6) are elevated, and patients typically have raised inflammatory markers like ESR and CRP. The immune profile shows changes in T cells and B cells consistent with an autoimmune‑type process, but there is no single characteristic autoantibody, so it is often described as immune‑mediated rather than classic autoantibody‑driven autoimmunity.
Environmental and infectious triggers
Several lines of evidence suggest that environmental factors can trigger PMR in predisposed individuals, including seasonal clustering of new cases and associations with infections. Proposed infectious triggers have included respiratory pathogens such as Mycoplasma pneumoniae, parvovirus B19, and other respiratory viruses, but none has been definitively proven as “the” cause.
Vaccines, comorbid disease, and other associations
Case reports describe PMR or PMR‑like syndromes occurring after influenza or other vaccinations, possibly as part of a broader autoimmune/inflammatory reaction, though this remains uncommon and causality is not firmly established. PMR is closely linked with giant cell arteritis and has reported associations with conditions like diverticulitis and, rarely, underlying malignancy, reinforcing the idea that systemic immune and inflammatory milieu, rather than a single external agent, drives the disease.
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4 Reactions@54pontiac
I do think it might be stress related, I had a stressful time 9 years ago and had my first symptoms of PMR. Today I have the same symptoms and a very painful flare up. Last year was also a very stressful time for me. I never believed that stress could be the cause of a disease but I guess I was wrong..?
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2 Reactions@54pontiac In early December '24 I had a planned trip to Patagonia. In the previous October, I developed a lot of pain in my knee and after an MRI, I was diagnosed with a torn meniscus. I was desperate to find relief so I could go on my trip. I tried many avenues to fix my problem but as the departure date got closer and closer to my trip, it seemed like I wasn't going to be able to go. This does sound trivial but I had my trip planned over a year before I was going and, in addition, I had two other friends that were joining me. By December 10th, I was diagnosed with PMR right after all of my attempts to get a quick fix for my knee. I believe I stressed myself out trying to find a way to be able to go on my trip.
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2 Reactions@ndep
I also think PMR is stress related. We moved to Idaho from California in 2018, then in 2022 decided to move back to California. While in the process of selling our house in Idaho it fell out of escrow twice. The second time we were notified within 30 minutes of the moving truck leaving with all of our possessions. We had to walk away from the house we were in escrow in California and lose our earnest money. Then we had to pay to get all of our stuff back. Six months later we relisted our house got a cash offer in three days and moved to California. Three months later I got hit with PMR. Couldn't raise my arms, turn my neck, rollover in bed or dress myself.
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3 Reactions@jiffaw
I think there is more a genetic link than people realize. Something triggers that gene, probably trauma from a wound or infection, and sets it in motion. Seems so unfair that most people on here who have led healthy lifestyles seem to be a target for this nasty disease.
@caroljeand
If PMR is anything like Reactive Arthritis (ReA) then there is a genetic predisposition that is triggered by an infection. The following link was updated recently.
https://www.ncbi.nlm.nih.gov/books/NBK537274/
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"Familial aggregation of PMR has suggested a genetic predisposition.[1] HLA class II alleles are found to be associated with PMR, and among these, the HLA-DRB1*04 allele correlates most frequently, seen in up to 67% of cases.[2] Genetic polymorphisms for ICAM-1, RANTES, and IL-1 receptors also appear to play a role in the pathogenesis of PMR in some populations.[3]
There were reports of increased incidence of PMR along with GCA during epidemics of mycoplasma pneumonia and parvovirus B19 in Denmark, suggesting a possible role of infection in etiopathogenesis.[4] The Epstein-Barr virus (EBV) has also been proposed as a possible trigger for PMR.[5] However, several other studies have not supported an infectious etiology hypothesis.[6][7]
There are also reports of an association between PMR and diverticulitis, which could suggest a role of a change in microbiota and chronic bowel inflammation in the immunopathogenesis of the disease.[8]"
@chpfireball. I bet that most of the people diagnosed with PMR have had the same type of experience and then onset as you describe. I, for one, had a similar series of events that were immediately (within 3-6 months) prior to my PMR. Stress seems to be the straw that breaks the camels back. Maybe not a sole cause (like genetics) but a very important component . Thanks for sharing your stress story. Hope that fiasco has been straightened out by now.
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1 Reaction@ndep
My body went through physical stress due to a traumatic injury to the foot requiring 7 stitches. I am sure that triggered it for me.
Any stress can cause the body to react in a way we can’t understand.