Flare?

[knoone]

Greetings from West Michigan, USA.

I was diagnosed with PMR/GCA 3.5 years ago. I have not been treated for any flares with these diseases but have gone up and down with prednisone due to infections that did not respond to antibiotics alone. The lowest dose of prednisone I was on was 2mg. I am currently on 7mg and not currently tapering due to having long covid symptoms. I am on weekly Actemra

Since having the covid infection 10 weeks ago I've had on and off pain in my left temple area as well as sore spots on my scalp. I have constitutional symptoms including fatigue, chills, and blurred vision. It's hard to know if these symptoms are covid related or PMRGCA related. My SED and CPR numbers are normal

Questions:

1. Are there scans or imaging that would show disease activity? If so, what kind?

2. What are the typical methods of diagnosing a flare?

3. How many mgs of prednisone is typically used to treat a flare and for how long?

I hate increasing the prednisone if I don't need to. I have a regularly scheduled appointment with my Rheummy on Monday and want to get a bit of a game plan for that meeting.

Sorry for all the questions.

Thank you for your help.

[PMRpro Ambassador]

I somehow doubt there is anything that could differentiate between Long Covid and GCA - PET-CT might show up inflammation but whether that is post-Covid or due to "just" GCA wouldn't be clear. Only biopsy can display the giant cells.

There are no methods - a return of symptoms and raised blood markers are usual, But post Covid, it is questionable how valuable markers are likely to be since they aren't specific to GCA.

It depends what is causing the flare - if it is overshooting the dose you need while tapering then adding 5mg to the dose where the flare occurred for a week to 10 days is usually enough before reducing straight back to the last dose you were good at. If it is a flare in disease activity - perfectly possible after Covid, then there is no answer. You have to go back to a dose high enough to manage the symptoms and start again.

[LIVEORDIEHEREIAM]

Just in case you haven't seen it directly, here is a link to SICK DAY RULES as regards the dosage of prednisone. When you click it, your computer will download a PDF that has a lot of information, including what to do if you get Covid-19. I keep a copy of this PDF in the PMR/GCA folder on my computer's desktop because when I'm sick, I don't want to be searching all over to find it!

medicinehealth.leeds.ac.uk/...

Oh, and don't be put off by it originating in the UK! These rules are good anywhere on earth!