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Polymyalgia Rheumatica (PMR) | Last Active: Jun 14 8:51pm | Replies (122)
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No one knows for sure if they have PMR. There is no lab test to "prove" PMR. If you have the correct type of pain in the correct places and you respond to prednisone then PMR is "confirmed". If your inflammatory markers are elevated, then that supports the Dx but lack of elevated inflammatory markers does not preclude a PMR Dx. Everyone treated for PMR is really never sure that is what they have. My understanding is if more than 20mg of prednisone is needed to cover the pain, then PMR is questionable. In practice I have no idea how this guideline is honored.
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@jabrown0407
"My understanding is if more than 20mg of prednisone is needed to cover the pain, then PMR is questionable. In practice I have no idea how this guideline is honored."
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It isn't because I needed more than 30 mg for a few years after I was diagnosed PMR. My rheumatologist was surprised when my inflammation markers were still high when I was on 30 mg of Prednisone for PMR. She told me to take 35 mg.
It is very common for patients with PMR to experience persistent inflammation and require higher or prolonged steroid dosages when there are overlapping health issues.
My rheumatologist simply said there was a lot of inflammation for a variety of reasons in addition to PMR. The implication was I had many problems and PMR was just one of them. Over time everything combined was called "systemic inflammation" rather than PMR alone. However, PMR was my "primary diagnosis" and that hasn't changed even though I'm off prednisone now. If anything ... Actemra more or less "confirmed" that PMR was my biggest problem but part of a "full range" of rheumatic conditions.