PMR Flare or is it actually GCA?

[Missus835]

For the last 4-5 days at least I've had what I thought were PMR symptoms recurring BUT I am at 30 mg. Pred since a GCA scare last Jan. 2023. They started me at 60 mg at that time, did a biopsy which of course was negative and ophthamology tests, which were negative. Nonetheless, I have always thought I had GCA and they look at me like I have two heads. The last couple of mornings, woke with bad headache up the back of my neck, into my head. ER doc said yesterday, he would not advise me to up the Pred without talking to my rheumy (eye roll). Regarding vision, it has declined and is sometimes double, where it was always 20/20 for distance. I've noticed this when watching the telly for which I have a distance prescription. Hands are swollen and stiff, shoulders won't reach back to get clothing on or on the loo is very difficult. Tops of thighs are tender, mid-back tender.

My questions: Can PMR flare at 30 mg. Pred or is it GCA or PMR/GCA? I need to know and of course rheumy is in self-induced seclusion. CRP as of yesterday was 3, so the extra 3 mg. of Pred 27 up to 30 (my decision) may have helped a bit. Would the symptoms of a GCA or PMR flare be the same? What tests would rheumy now do to determine GCA? Another biopsy? I'm up for anything if someone would just listen. I just don't know who to ask anymore, except this forum. Thank you.

Perhaps I should wait to see if this Rx for antibiotics kicks in as ER doc thinks inflammation is due to UTI or diverticulitis.

[DorsetLady PMRGCAuk volunteer]

Can PMR flare at 30 mg. Pred?

I would say, unlikely...but not totally unheard of especially with some of the symptoms you describe which sound more PMR ish than GCA - apart from headaches.

Vision changes can be affected by Pred, particularly at higher doses.

Any increase in dose is likely to reduce your inflammatory markers, whatever is causing them.

Think you need to let the abx do their work, and then follow up on your other issues...or which there seem to be many...unfortunately 😔

[Missus835 in reply to DorsetLady]

Thanks DL. There are many issues. LOL. I will take your advice and wait for the rx to do it's work. Hopefully, since I've attempted to contact rheumy through various channels, she will get back to me eventually.

[DorsetLady PMRGCAuk volunteer in reply to Missus835]

Certainly hope so too!