Infections & Flareups

[JOHNONE28]

I was first diagnosed with PMR 4yrs ago & During this time have had a pretty smooth journey. On 2 occasions I have managed to reduce down to 2mg of pred, before having minor flare ups consequently then having to increase my dose again. Up to a week ago, I was on 5mg & on top of the world. Then I felt very poorly with "flu" like symptoms, shivering, vomiting also a burning sensation when passing water. Fearing an infection & understanding that an infection can increase the chance of a flare up I increased my dose of pred to 10mg went to see my GP who prescribed a course of antibiotics. However the some of the symptoms have persisted achy no energy day time sleeping & feeling generally very poorly, all typical symptoms of my PMR so over the weekend I increased my preds up to 15mg & bingo everything back to normal. My problem now is how long will I need to stay on15mg before reducing again also will I need to follow the previous long reduction plan

[PMRpro Ambassador]

It depends - a UTI is a common cause of a flare because it upsets the immune system. Since you were right down at 5mg you may be able to go from 15 to 10 after just a few days and it shouldn't be a problem. and then try a further reduction more slowly.

However - I had a flare in January last year and had to go back to 15mg, it was a few months before I could reduce to 13mg, 1mg at a time, The first few times I tried the symptoms were back. It took until autumn to get to 10mg and there I got stuck. Getting my GP to deal with some separate back muscle problems let me get to 8mg - and another session allowed 7mg. It depends on whether your flare was only due to the UTI (in which case once it is gone you should be able to get back to a lower dose) or whether this is a real flare in activity. In which case it will be harder to reduce as the whole disease activity may have changed.