Do I really have PMR or was it Pneumonia

[yorkieme]

In December my GP put me on steroids after I described the pain etc, associated with what he decided was PMR The pain went away for a few days but came back worse than ever within the week.I was abroad for five weeks at the time the pain returned and got through using tramadol for the intense pain.Since coming back home tests/CT/Xray show I had pneumonia at the time and it hasn't cleared up,(now on heavy anti biotic course,) I have non hodgkins lymphoma.Is it possible the PMR diagnosis could be wrong ? still on 30mg pred'

Could the pneumonia have kicked in the PMR indicators of pain down my shoulders,arms,buttocks and thighs ? I am new on this forum so quite unsure,have done loads of research but still don't know enough to decide.Help/ would be great thanks.

[SheffieldJane]

There will be links in that the Pneumonia could have been the last straw for your immune system triggering PMR. You must have felt quite awful. The symptoms you mention are pretty usual for PMR. How are you being treated, medically?

[yorkieme in reply to SheffieldJane]

First of all thanks for the rapid response.I am on 35mg prednisolone was 60mg per day but decided to reduce it 5mg per week just to see where any return pain threshold might kick in,so far no pain or symptoms but I am going to get down to 20mg before going back to the GP. The point you make is the one I am trying to establish,did the non hodgkins/pneumonia combination cause the problem ? I was reasonably fit and very active but suddenly this immense pain arrived for no apparent reason and since then no definite view from the GP or rheumatoid arthritis specialist. I have a feeling I may not have PMR but while on steroids I guess I can't know for sure.

[Hidden in reply to yorkieme]

If that pred dose was just for the PMR dx then it was far to much. Usually 25mg is the dose to help dx PMR. Some need more but 60mg is a GCA dose. Did you have GCA symptoms? Is anyone monitoring you or helping you reduce. I am not sure it's possible to answer your question until your dose is reduced slowly and significant.

Non Hodgkin's , if I remember rightly, can be "mistaken" for PMR initially and is a differential dx. But I didn't read the full article...jyst the abstract. If tramadol helped the pain then I doubt PMR as I was taking around 600mg a day, up from usual 400mg and it didn't help at all.

The main thing is don't stop the steroids and confer with your DR.

[yorkieme in reply to Hidden]

Much appreciated advice,I hope to get down to around the original 15mg then contact my GP.

[PMRpro Ambassador]

Do you know what the rationale was for starting you on 60mg pred? That is far too high for just PMR and if the pain was still a problem with that, it is pretty likely that whatever it was, it wasn't PMR. Especially if tramadol made a difference.

You can't just stop the pred altogether but you can reduce rapidly down to 10mg. Some of the symptoms of non-Hodgkins over lap with PMR so it might be difficult to sort out.

[yorkieme in reply to PMRpro]

Thanks for your response.Initially the GP prescribed 15mg pred on the basis of PMR,he then looked at my record and could see recent eye issues and put the dose up to 60mg on the basis of temporal arteritis.I was diagnosed in 2017 with non hodgkins but no treatment as yet.Tramadol slow and fast acting versions helped for a few hours but the side effects were crazy so I stopped using them.

I am choosing to come down on the pred to around 15mg before contacting the GP.They are so busy due to the covirad-19 issue.