Possible RA now?

[nymima01]

Hello - I haven’t written in a while. I was diagnosed with PMR in Dec of 2016. I am still tritating down on Prednisone, and I’m at 3 mgs now. During this time, I was also diagnosed with Non-Hodgkins Lymphoma in May of 2017. It was decided that the PMR was a “differential diagnosis” to the lymphoma. I treated with an immune-therapy drug called Rituxan and this worked well for my lymphoma and ALSO my CRP and ESR numbers. Both dropped down to under 5. I felt great for the rest of the year 2017, and as far as I know, I am still in remission for the NH Lymphoma.

Now - My question is this: I have had extreme pain in my lower back and hips lately. I recently had a blood test for my Rheumatologist and I also had a cat scan for my lymphoma. I will find out next week the results of these tests. In the meantime, I am wondering if I could possibly be experiencing some actual RA symptoms now? My body feels very inflamed. I am eating good and trying to stay as healthy as possible. But these flares of inflammation feel as if something else is developing. Does anyone know if PMR can go into full-blown RA or some form of RA? If my CRP numbers are still in a good range, then I don’t really know what to make of things. I’m afraid my Rheumatoid will tell me that if my inflammation numbers are good, then it can’t be a rheumatoid condition. (My blood work from the oncologist is really good). I am definitely in a lot of pain in my lower back and hips. I am going to ask the rheumatoid for an anti-inflammatory despite what he might say.

[PMRpro Ambassador]

Do you mean they decided that you had both non-Hodgkin's lymphoma and PMR? Non-Hodgkin's can present like PMR.

RA, particularly late onset RA, can present looking like PMR, especially when it is sero-negative.

However, there are a couple of things that can cause low back pain that are more common alongside PMR but can occur on their own: myofascial pain syndrome and piriformis syndrome. Both lead to spasmed muscles and low back and hip pain is common. Another cause of hip pain can be bursitis.

But I'm a bit mystified why your assumption is of RA?

[nymima01 in reply to PMRpro]

Hi PMRpro - I had a tumor in my spleen. So my actual diagnosis was Marginal Zone, B cell, splenic NH lymphoma. I studied my blood work for a tranlslation of certain markers and I also had a bone marrow test that indicated this cancer.

I just feel that my joints are so inflamed below my lower back. So lower back, hips, knees especially. It’s a different feeling than having pulled my back out.

I was just wondering if PMR can convert to actual RA I guess. I know I am low on the prednisone count now and I feel fine except for the painful inflammatory response I am currently dealing with. I don’t have the exceptional fatigue that I had when I tested positive for PMR.

[PMRpro Ambassador in reply to nymima01]

There are absolutely NO definitive markers to say that PMR-type symptoms are due to the PMR we talk about here. So there is no way to say that your symptoms were PMR - they COULD have been due to the tumour, that is one of the things that must be ruled out when a patient turns up with the symptoms. The same applies for RA - it may have presented with "just" PMR-type symptoms, but that is not the same as PMR turning into RA - the diagnosis was mistaken. There is as yet no evidence that PMR can turn into RA - but a patient with PMR symptoms might have RA - and it isn't uncommon for the diagnosis to be changed.

However - everyone I know with RA complains of fatigue. And the pain and symptoms I get with MPS are very difficult to distinguish from PMR. That is what I mean - it is very difficult to tell.

[SheffieldJane]

Good luck with your test results.